No.

Earthquake Rehabilitation and Reconstruction Agency The Islamic Republic of Pakistan

OUTLINE DESIGN STUDY REPORT ON THE PROJECT FOR THE RECONSTRUCTION OF THE EARTHQUAKE-AFFECTED FACILITIES IN NORTH WEST FRONTIER PROVINCE IN THE ISLAMIC REPUBLIC OF PAKISTAN

December 2006

JAPAN INTERNATIONAL COOPERATION AGENCY

NIPPON KOEI CO., LTD. BINKO INTERNATIONAL LTD.

GM JR 06-237 PREFACE

In response to a request from the Government of the Islamic Republic of Pakistan, the Government of Japan decided to conduct an outline design study on the project for the reconstruction of the earthquake-affected facilities and entrusted the study to the Japan International Cooperation Agency (JICA).

JICA sent to Pakistan a study team for five field surveys during the period from January 25 to July 12, 2006.

The team held discussions with the officials concerned of the Government of Pakistan, and conducted a field study at the study area. After the team returned to Japan, further studies were made. As this result, the present report was finalized.

I hope that this report will contribute to the promotion of the project and to the enhancement of friendly relations between our two countries.

I wish to express my sincere appreciation to the officials concerned of the Government of the Islamic Republic of Pakistan for their close cooperation extended to the teams.

December, 2006

Kuroki MASAFUMI Vice President Japan International Cooperation Agency December, 2006

LETTER OF TRANSMITTAL

We are pleased to submit to you the outline design study report on the project for the reconstruction of the earthquake-affected facilities in North West Frontier Province in the Islamic Republic of Pakistan.

This study was conducted by the Consortium of Nippon Koei Co., Ltd. and Binko International Ltd., under a contract to JICA, during the period from January, 2006 to December, 2006. In conducting the study, we have examined the feasibility and rationale of the project with due consideration to the present situation of Pakistan and formulated the most appropriate outline design for the project under Japan’s Grant Aid scheme.

Finally, we hope that this report will contribute to further promotion of the project.

Very truly yours,

Yoshikimi INOUE Project Manager, Outline design study team on the Project for the Reconstruction of the Earthquake-Affected Facilities in North West Frontier Province in the Islamic Republic of Pakistan The Consortium of Nippon Koei Co., Ltd. and Binko International Ltd. SUMMARY

(1) Existing Conditions of the Country

The Islamic Republic of Pakistan (hereinafter referred to as Pakistan) is located in Southwest Asia and surrounded by neighboring countries of India, Afghanistan, and Iran. Pakistan has a national land area of 796,000 km2 and a population of 155.4 million in 2005.

Nearly 60% of the total land of the country consists of dry or semi-dry climate, and about 60% of the population resides in Punjab plains in the central part. Mountains encompasses widely in the northern part area forming the forest range, with more than 60 mountain peaks beyond 6,700m. Among them, K-2 (8,611m) is a second highest mountain in the world. In summer from April to September The southern part and the low ground part become high temperatures of over 40 degree, while the northern part is clement. During winter, It becomes 10 to 20 degree in the south, while the northern part experiences below freezing point.

The main industries of the national economy are agriculture and cotton industries. A gross domestic product (GDP) by industry in 2005 was estimated at 21.6% for agriculture, 25.1% for manufacturing, and 53.3% for service. GDP per capita in the same year was 847 USD/person.

(2) Background of the Project A magnitude 7.6 earthquake occurred in Pakistan at 8:50 a.m. on 08 October 2005. The earthquake epicenter was located 100 kilometers north-northeast of Islamabad. The provinces of Azad Jammu and Kashmir (AJK) and the northern districts of the North West Frontier Province (NWFP) bore the full force of the earthquake in terms of number of lives lost, injuries sustained, and destruction of infrastructure and economic assets. According to the Government of Pakistan figures, as of November 3, approximately 73,000 people had died and more than 70,000 had been severely injured or disabled. Over 2.8 million persons have been left without shelter, and it is estimated that about 2.3 million persons are without adequate food. The Government of Pakistan submitted a request to the Government of Japan for Non-Project Grant Aid for the project for the reconstruction of the earthquake-affected facilities in North West Frontier Province (hereinafter referred to as “the Project”). The Government of Japan entrusted an outline design study for the Project to the Japan International Cooperation Agency (hereinafter referred to as “JICA”). JICA dispatched an outline design study team to Pakistan. The study team conducted surveys from January 23 to February 02, 2006 and confirmed the necessity, urgency, and appropriateness of this Project. Finally, the Government of Pakistan and the study team agreed on February 02, 2006 to carry out the outline design study on the reconstruction of earthquake-affected facilities for health and education sectors as the first priority and infrastructure sector as the second priority.

People in the Battagram district are poorly provided with health facilities, of which the preparedness is evaluated at the lowest level among the districts in NWFP because the health facilities in the district are not accessible by roads suited for the vehicle transportation from residential areas, and water supply and sanitation systems are not provided. In addition to those reasons, the low literacy rate in the district obstructs the prophylaxis education.

－S-1－ After the earthquake, the Pakistani government, NGOs, and Donors provided first-aid services for the affected peoples at temporally facilities and tents. However, the affected facilities are still not rehabilitated or reconstructed according to a mid-long term plan. Therefore, the Pakistani government requested the reconstruction of 34 earthquake-affected health facilities together with medical equipment in Allai Tehasil (county) and Battagram Tehasil in the Battagram district as presented in the table below.

Table 1: Health Facilities Requested for Reconstruction Health Facilities Quantity (nos) District Headquarters (DHQ) 1 Rural Health Centers (RHC) 2 Basic Health Units (BHU) 28 Civil Hospital (CH) 1 Tuberculosis Control Center (TBC) 1 Executive District Office (EDO) 1 Total 34 Note: The DHQ includes the Mother and Child Health Center (MCHC).

Primary and secondary education is formed by four different education levels that consist of the primary (for the first five years), middle (for the following three years), high (for the next five years), and high secondary (for the final two years) levels. From the primary levels, schools are separated for boys and girls. The number of schools affected in the primary level was estimated at 605 (equivalent to 90% of the total number of schools in this level), 44 in the middle level (95%), and 26 in the high and high secondary levels (72%). The total number of the schools affected was 675 that was equivalent to 92% of the total 727 schools in the district. Among those schools affected, the Pakistani government requested the reconstruction of 411 earthquake-affected schools that consist of 363 primary schools, 25 middle schools, and 411 high and high secondary schools. In addition to the 411 schools, the Pakistani government requested the reconstruction of a boys’ degree college.

Table 2: Education Facilities for which Reconstruction was Requested Education Facilities Number of Affected Facilities Number of Facilities Requested (nos) (nos) Primary school 605 363 Middle school 44 25 High and high secondary school 26 23 Boys’ degree college 1 1 Total 675 411

As the second priority sector, the Pakistani government requested the reconstruction of bridges at seven locations, main access roads on seven routes with a total length of 128 km, and community roads on 14 routes with a total length of 227 km.

(3) Basic Concept of the Project The outline design study team conducted a field survey and confirmed the necessity, urgency, and appropriateness of the Project. The study team prepared the criteria for selecting the facilities to be reconstructed in the Project as listed below.

• Health sector: i) damage level, ii) accessibility, iii) site conditions, iv) number of doctors and medical staffs, v) number of outpatients, and iv) activities of other donors.

• Education sector: i) damage level, ii) accessibility, iii) number of students and teachers, iv) site

－S-2－ conditions, v) number of classrooms, vi) activities of other donors, vii) existing conditions of neighboring schools, and viii) land ownership.

• Infrastructure sector (roads and bridges): i) damage level, and ii) contribution to the access improvement to the selected educational and health sector facilities.

Then, the study team and the Pakistani government selected and agreed to the facilities to be reconstructed in the Project as presented in the table below. The study team and the Pakistani government selected 17 basic health units for the reconstruction; however the Pakistani government thereafter requested to upgrade four basic health units at Paimal Sharif, Rashang, Pashoto, and Shumlai to rural health centers. Since the additional request by the Pakistani government required new sites adequate for the upgrading the BHUs, the four BHUs were temporarily excluded from the selected facilities for reconstruction.

Table 3: Selected Facilities to be reconstructed in the Project Sector Facilities Quantity (nos) Health District Headquarters (DHQ) 1 (19 facilities and medical equipment) Tuberculosis Control Center (TBC) 1 Mother and Child Health Center(MCHC) 1 Executive District Office (EDO Office) 1 Rural Health Center (RHC) 1 Civil Hospital (CH) 1 Basic Health Units (BHU) 13 Education Government Primary Schools (GPS) 63 (118 facilities in total) Government Girls Primary Schools (GGPS) 43 Government Middle Schools (GMS) 2 Government Girls Middle School (GGMS) 1 Government High Schools (GHS) 7 Government High Secondary School (GHSS) 1 Boys Degree College 1 Road and Bridge (3 locations in total) Bridges No. 3, No. 6, and No. 7 3 Note: The number of BHUs excludes the four BHUs at Paimal Sharif, Rashang, Pashoto, and Shumlai. (4) Construction Schedule and Cost Estimation The project period was estimated at 25 months from the signing of the exchange of notes (E/N) to the completion of the construction. The implementation cost was estimated at 3,094 million yen (3,093 million yen by the Japanese government and one million yen by the Pakistani government).

(5) Project Evaluation and Recommendations

Direct beneficiaries of the implementation of the Project were estimated at 302,000 outpatients and 144 medical experts in the health sector and 3,700 students and 455 teachers in the education sector. In addition to those beneficiaries, the Project was expected to indirectly contribute to the living environmental improvement for the families and relatives of the direct beneficiaries.

Since the Project aimed at the reconstruction of the earthquake-affected facilities, the Project would not require any additional costs for operation and maintenance. Therefore, the Pakistani government was recognized capable to operate and maintain the facilities reconstructed in the Project.

The study team pointed out the issues that must be addressed in order to implement the Project efficiently and effectively as mentioned below.

(1) Housing construction for doctors and medical staffs: There were many vacancies for doctors in the rural areas. Because the sphere of daily existence was extremely limited in the narrow area in the Battagram district due to the precipitous topography in the mountainous regions and low preparedness of

－S-3－ infrastructure, it was not unusual that there was no doctor in villages. In addition to the insufficient number of the doctors in the district, female doctors were limited to one senior doctor and one obstetrician and gynecologist in the DHQ. Low provision of the female doctors is another important issue in the health sector in the district. Although the Pakistani government made efforts to improve the medical services, most of educated medical experts wanted to stay in the urban areas. Therefore, the housing for doctors and medical staffs needed to be constructed at the sites of the selected health facilities to provide an incentive for allocating the medical experts.

(2) Employment of teachers: During the site survey, the study team discovered that there were three high secondary schools (GHS Battamori, GHS Shamlai, and GHS Biari) of which school buildings were constructed and could not be opened for one year because the NWFP governments could not employ teachers for these schools. Those high secondary schools were thereafter destroyed by the earthquake. Therefore, the Pakistani government needed to confirm the availability of teachers who would be employed for the schools to be reconstructed in the Project.

(3) Improvement of accessibility: Access to the affected schools relied on the inconvenient routes of narrow streets, terraced fields, rivers, and slopes. Students and teachers are forced to walk on those inconvenient routes. Schools accessible by vehicle transportation were rare among the schools of the Project. Construction materials and consumer goods were transported by donkeys to the schools inaccessible by vehicle transportation. On the other hand, the Pakistani government requested to adopt a universal design including ramps and other methods, which provided access for disabled persons. The outline design team took into account the better accesses within the schools; however the most important issue was to provide better access between the residential areas and the schools. Since the Project did not include the improvement of the accessibility, the Pakistani government was therefore responsible to provide and improve the access roads.

－S-4－ Outline Design Study Report on the Project for the Reconstruction of the Earthquake-Affected Facilities in North West Frontier Province in the Islamic Republic of Pakistan

Preface Letter of Transmittal Summary Contents Location Map List of Figures & Tables Abbreviations

Contents

Chapter 1 Background of the Project...... 1-1

Chapter 2 Contents of the Project ...... 2-1 2-1 Basic Concept of the Project...... 2-1 2-2 Outline Design of the Requested Japanese Assistance...... 2-7 2-2-1 Design Policy ...... 2-7 2-2-2 Basic Plan (Construction Plan/ Equipment Plan) ...... 2-10 2-2-3 Outline Design Drawing ...... 2-23 2-2-4 Implementation Plan...... 2-23 2-2-4-1 Implementation Policy...... 2-23 2-2-4-2 Implementation Conditions ...... 2-24 2-2-4-3 Scope of Works...... 2-26 2-2-4-4 Consultant Supervision ...... 2-27 2-2-4-5 Quality Control Plan...... 2-29 2-2-4-6 Procurement Plan...... 2-30 2-2-4-7 Operation Guidance Plan ...... 2-31 2-2-4-8 Implementation Schedule...... 2-31 2-3 Obligations of Recipient Country ...... 2-33 2-4 Project Operation Plan...... 2-33 2-5 Project Cost Estimation ...... 2-36 2-5-1 Initial Cost Estimation ...... 2-36 2-5-2 Operation and Maintenance Cost ...... 2-37 2-6 Other Relevant Issues...... 2-39

- i - Chapter 3 Project Evaluation and Recommendations ...... 3-1 3-1 Project Effect ...... 3-1 3-2 Recommendations ...... 3-2

[Appendices] A.1 Member List of the Study Team ...... AP-1 A.2 Study Schedule ...... AP-3 A.3 List of Parties Concerned in the Recipient Country...... AP-6 A.4 Minutes of Discussions ...... AP-8

[Annex] Annex 1 Drawing List (Health Sector) ...... AN1-1 Annex 2 Drawing List (Education Sector) ...... AN2-1 Annex 3 Drawing List (Bridge)...... AN3-1 Annex 4 Damage to Existing Health Facilities...... AN4-1 Annex 5 Damage to Existing Education Facilities ...... AN5-1 Annex 6 Damage to Existing Roads and Bridges...... AN6-1 Annex 7 Site conditions and Facility plan of education facilities...... AN7-1 Annex 8 List of Medical Equipment to be Provided in the Project ...... AN8-1

- ii -

LOCATION MAP

HEALTH FACILITES REQUESTED FOR RECONSTRUCTION

HEALTH FACILITES SELECTED FOR RECONSTRUCTION

EDUCATION FACILITES REQUESTED FOR RECONSTRUCTION

EDUCATION FACILITES SELECTED FOR RECONSTRUCTION LIST OF FIGURES & TABLES

Table 1.1: Medical Facilities for which Reconstruction was Requested ...... 1-1 Table 1.2: Education Facilities Requested for Reconstruction ...... 1-1 Table 1.3: Roads for which Reconstruction was Requested...... 1-2 Table 1.4: Bridges for which Reconstruction was Requested...... 1-2 Table 2.1: Criteria for Selecting the Facilities to be Reconstructed (Health Sector)...... 2-1 Table 2.2: Criteria for Priority Health Facilities to be Reconstructed in the Project ...... 2-2 Table 2.3: Criteria for Priority Schools to be Reconstructed in the Project...... 2-4 Table 2.4: Summary of Priority Schools to be Reconstructed in the Project...... 2-5 Table 2.5: Schools not to be selected and the Reasons...... 2-5 Table 2.6: Evaluation of Bridges for which reconstruction was requested...... 2-6 Table 2.7: Classification of Health Facilities...... 2-8 Table 2.8: Basic Plan for DHQ ...... 2-10 Table 2.9: Basic Plan for Banna RHC ...... 2-12 Table 2.10: Basic Plan for Thakot CH...... 2-14 Table 2.11: Basic Plan for BHU ...... 2-15 Table 2.12: Residential Facilities according to the Positions of the Health Workers ...... 2-16 Table 2.13: Specifications for the Main Medical Equipment ...... 2-16 Table 2.14: Main Medical Equipment for Department in the DHQ ...... 2-17 Table 2.15: Types of Classroom Buildings ...... 2-19 Table 2.16: Dimensions of Latrines...... 2-19 Table 2.17: Planned construction methods ...... 2-21 Table 2.18: Furniture Plan ...... 2-22 Table 2.19: Basic Plan for Boys Degree College and High Secondary School...... 2-22 Table 2.20: Qualification for Tenderers...... 2-25 Table 2.21: Responsibilities of Japanese and Pakistani sides...... 2-26 Table 2.22: Scope of Works by Package...... 2-26 Table 2.23: Scope of Works by the Consultant...... 2-29 Table 2.24: Supplier Countries of Main Equipment ...... 2-31 Table 2.25: Position and Education Level of Personnel of Abbottabad Sub-Workshop...... 2-34 Table 2.26: Operation Budgets of Medical Facilities ...... 2-38 Table 2.27: Operation and Maintenance Costs for Bridges to be Reconstructed ...... 2-38 Table 3.1: Project Effect in the Health Sector...... 3-1 Table 3.2: Project Effect in the Education Sector...... 3-1 Table 3.3: Project Effect in the Infrastructure Sector (bridge)...... 3-2

Figure 2.1: Structure of Project Execution ...... 2-27 Figure 2.2: Implementation Schedule...... 2-32 Figure 2.3: Procurement Implementation Processes (Proposal)...... 2-33

Figure 2.4: Organization Chart of Maintenance/Control Workshop...... 2-34

ABBREVIATIONS

1 Name (1) Organization ADB Asia Development Bank ERRA Earthquake Reconstruction & Rehabilitation Authority GTZ Deutsche Gesellschaft fur Technische Zusammenarbeit JICA Japan International Cooperation Agency JICS Japan International Cooperation System NGO Nongovernmental Organization NWFP North West Frontier Province SADC Swiss Agency for Development and Cooperation WB World Bank WFP World Food Program WHO World Health Organization (2) Health sector ARI Acute Respiratory Infectious BHU Basic Health Unit CCU Coronary Care Unit CD Civil Dispensary CH Civil Hospital DHQ District Head Quarter Dia. equal to Traditional Birth Attendant Dis. Dispenser EDO Executive District Office ENT Ear, Nose and Throat EPI Expanded Programme of Immunization LHV Lady Health Visitor MCHC Mother and Child Health Center MO Medical Officer MD Medical Doctor MT Medical Technician Ob/Gy Obstetric and Gynecology OPD Outpatient Department RHC Rural Health Center SS Sub-Specialty TBC Tuberculosis Control Center THQ Tehasil Headquarter (3) Education sector BDC Boys Degree College EMIS Education Management Information System

GGMS Government Girls Middle School GGPS Government Girls Primary School GHS Government High School GHSS Government High Secondary School GMS Government Middle School GPS Government Primary School PTA Parent-Teacher Association (4) Others BHN Basic Human Needs CE Communauté Européenne E/N Exchange of Notes GDP Gross Domestic Product ISO International Organization for Standardization M/D Minutes of Discussion PC Planning Commission SAC Structure Adjustment Credit

2 Unit Area Volume mm2 = Square-millimeters (1.0 mm x 1.0 mm) cm3 = Cubic-centimeters (1.0 cm x 1.0 cm x 1.0 cm) cm2 = Square-centimeters (1.0 cm x 1.0 cm) m3 = Cubic-meters (1.0 m x 1.0 m x 1.0 m) m2 = Square-meters (1.0 m x 1.0 m) L = Liter (1,000 cm3) km2 = Square-kilometers (1.0 km x 1.0 km) ha. = Hectares (10,000 m2) Length Weight mm = Millimeters mg = Milligram cm =Centimeters (= 10 mm) g = Grams (= 1,000 mg) m = Meters (= 100 cm) kg = Kilograms (=1,000 g) km = Kilometers (= 1,000 m) ton, t = Metric tonne (=1,000 kg) ” =Inch (= 2.54 cm) ’, ft = Feet (= 12 inches) Currency Time US$, $ = United State Dollars sec, s = Seconds (US$1.0 = 116 yen) JPY, Yen = Japanese Yen min = Minutes (= 60 sec) Rs = Pakistan Rupee (Rs 1.0 = 2.11 yen) hr, h = Hours (= 60 min) d = day Other V, v = volt W, w = watt Hz = Hertz % = Percent N = Newton

CHAPTER 1

BACKGROUND OF THE PROJECT CHAPTER 1 BACKGROUND OF THE PROJECT

A magnitude 7.6 earthquake occurred in Pakistan at 8:50 a.m. on 08 October 2005. The earthquake epicenter was located 100 kilometers north-northeast of Islamabad. The provinces of Azad Jammu and Kashmir (AJK) and the northern districts of the North West Frontier Province (NWFP) bore the full force of the earthquake in terms of number of lives lost, injuries sustained, and destruction of infrastructure and economic assets.

In a response to the huge disaster caused by the earthquake, the Government of Pakistan requested that the Government of Japan reconstruct the earthquake-affected facilities for the health and education sectors as the first priority and the infrastructure sector as the second priority.

(1) Health Sector

Most of health facilities located in the Battagram Tehasil and Allai Tehasil were affected by the earthquake. The Pakistani government, NGOs, and donors provided first-aid services and medical services for the affected people in temporary tents. The Pakistani government requested that the Japanese government reconstruct 34 earthquake-affected medical facilities as presented in the table below.

Table 1.1: Medical Facilities for which Reconstruction was Requested Medical Facilities Quantity (nos) District Headquarter (DHQ) 1 Rural Health Centers (RHC) 2 Basic Health Units (BHU) 28 Civil Hospital (CH) 1 Tuberculosis Control Center (TBC) 1 Executive District Office (EDO) 1 Total 34 Note: The DHQ includes the Mother and Child Health Center (MCHC).

(2) Education Sector The Pakistani government requested that the Japanese government reconstruct one boy’s degree college and 411 schools that included 363 primary schools, 25 middle schools, and 23 high and high secondary schools as presented in the table below.

Table 1.2: Education Facilities Requested for Reconstruction Type of School Damaged Schools (school) Reconstruction Enrollment Requested Destroyed (schools) (persons) (school) (person) 1) GPS 256 140 396 252 31,500 2) GGPS 115 94 209 111 15,364 Sub-total 371 234 605 363 46,864 3) GMS 16 13 29 17 1,665 4) GGMS 7 8 15 8 369 Sub-total 23 21 44 25 2,034 GHS 14 8 22 22 3,413 GGHS 1 2 3 0 612 GHSS 1 0 1 1 166 Sub-total 16 10 26 23 4,191 Total 410 265 675 411 53,089 Source: Information obtained from the office of executive district officers, the school & literacy department, Battagram Note: Enrollment is as of the school year 2005.

－1-1－

(3) Infrastructure Sector (Road and Bridge)

The Pakistani government requested the reconstruction of seven bridges, main access roads of seven routes with a total length of 128 km, and community roads of four routes with a total length of 217 km as presented in the table below.

Table 1.3: Roads for which Reconstruction was Requested Location Road Length (km) Battagram Tehasil Main access roads （district roads） 1 Oghi Battagram Road 15 2 Kuzabanda Chattarplain Road 24 3 Battagram Shumlai Hill Road 26 4 Battagram to Paimal, Rangeen Abad, Surgai Road 22 Community roads 5 Landikass Perijhari Road 13 6 Joz Road 4 7 Lachmaira Road 4 8 Gajkot Battoian Road 5 9 Japan Bridge to Kotgalla Road 3 10 Kohani Merani Road 13 11 Bilandkot Road 4 12 Hill to Malikan Gali Road 5, Sub-total 138 Allai Tehasil Main access roads （district roads） 1 Kund Banna Road 20 2 Biari Gidri Road 9 3 Karrag Jabbar Road 12 Community roads 4 Talious Pashto Road 12 5 Banna Bateela Road 8 6 Asharban Banna Road 6 7 Bela Pazang Road 5 8 Sakargah Darra Road 4 9 Kuntar Gat Sheeshal Road 3 Sub-total 79 Total 217

Table 1.4: Bridges for which Reconstruction was Requested Location Bridges Lengs, Width (m) Battagram Tehasil Shumrai 33.5, 2.5 Battagram college 16.5, 4.6 Pashto 15、 4.8 Allai Tehasil Rope Kanai 45, 1.5～ 2.0 Banna 22.5, 4.6 Besham 20, 5.0 Bahari 32, 4.6

(4) Natural Conditions

The project sites were located in mountainous areas with the highest elevation of 4689 m. Since there were no weather observation offices in the Battagram district, there was no official weather data. According to the Manshera weather observation office that was located in the district neighboring the project sites, the average temperature fluctuated in the range from 21 ℃ to 35 ℃ in the summer and from 2 ℃ to 14 ℃in the winter. The annual average rainfall was in the range from 1000 to 2000 mm/year. In the winter, it snowed in the northern part and highlands of Battagram district. Access roads to the district were closed by snow in the winter.

－1-2－

(5) Environmental and Social Consideration

The Project will be implemented to reconstruct the affected facilities for the health, education, and infrastructure sectors. The new facilities will be reconstructed at the sites of the old facilities. Therefore, the Project will not cause any negative impacts in view of environmental and social considerations.

－1-3－

CHAPTER 2

CONTENTS OF THE PROJECT CHAPTER 2 CONTENTS OF THE PROJECT

2-1 BASIC CONCEPT OF THE PROJECT

(1) Overall Goal

The overall goal of the Project was to rehabilitate the health and education services that were affected by the earthquake in the Battagram Tehasil and Alli Tehasil. To achieve this overall goal, the purpose of the Project was aimed at the reconstruction of bridges and facilities for the health and education sectors.

(2) Selection of Facilities to Be Reconstructed in the Project (Health Sector)

An outline design study team carried out the field survey and evaluated the 34 health facilities that were requested for reconstruction by the Pakistani government. Then, the study team prepared the criteria to select the health facilities which will be reconstructed in the Project as presented in the table below.

Table 2.1: Criteria for Selecting the Facilities to be Reconstructed (Health Sector) Criteria Description (1) Extent of damage • Priority was placed on a facility of which damage was visually observed. • Since it was difficult to evaluate the extent of structural damages in the limited time of the field survey, buildings of which damage was not confirmed and still used were excluded from the Project. (2) Accessibility • High priority was placed on a facility easily accessible by car. • Since most of health facilities were not accessible by car, medium priority was placed on a facility which was accessed on foot and to which construction materials were transported by donkey and human power. • Low priority was placed on a facility to which the study team could not gain access due to the hazards of landslides and rock falls. (3) Site conditions • A project site hazardous for rock fall was excluded from the Project. • Priority was placed on a facility for which the provincial government provided an alternative site. (4) Number of health workers of a heath facility • A facility without any doctors was excluded from the Project. (5) Number of outpatients • Priority was decided based on the number of outpatients. (6) Activities of other donors • Low priority was placed on a facility that was supported by other donors or NGOs. • WHO was reconstructing eight basic health units’ outpatient wards. The reconstructed wards will be temporary steel structures. WHO agreed that those temporary wards will be used for storage and residences for medical workers if the Japanese government will decide to reconstruct permanent structures. Therefore, high priority was placed on those eight outpatient wards.

Based on the selection criteria, the study team and the Pakistani government selected the health facilities to be reconstructed in the Project. The selected health facilities included a DHQ, a TBC, a MCHC, an EDO, an RHC, a CH, and 17 BHUs. Among the 17 BHUs, the Pakistani government requested to expand four BHUs to RHCs. Those BHUs were located at Paimar Sharif, Rashang, Pashoto, and Shumlai. Since the expansion of the four BHUs required alternative sites larger than the existing sites, those four BHUs were tentatively excluded from the Project. A decision for those BHUs will be made after confirmation of alternative sites which will be provided by the Pakistani government.

－2-1－

Table 2.2: Criteria for Priority Health Facilities to be Reconstructed in the Project Criteria of Reconstruction Priority Scope of Reconstruction

Damaged Status

Number of

n

No. Medical Facility o y y i t

Outpatient i d n Access Access Co No. of Staff No. of OPD Situation Aid Donors' OPD OPD Ward Doctors' House Dormitory Staff Guard's Dormitory Recovery Priority OPD Doctors' House Staff Dormitor Guard's Guard's Dormitor 1 DHQ Hospital Battagram 120,000 A A A A A A － AA －－ Re-construction of whole facility 2 RHC Banna 28,800 A A A A A A － AA －－ Re-construction of whole facility 3 EDO (Health) Office A － － － － A －－－－ Re-construction of facility 4 District TB Control Office 11,000 A － － － － A －－－－ （Re-construction in DHQ） 5 RHC Kuzabanda 7,200 C C B B C A － A －－ － － － － － 6 CH Thakot 108,000 A A A A A A － AA －－ 1 － 1 1 1 7 BHU Shumlai 4,800 A A A A A A B B C C 1 1 1＜ 1＜ 1 8 BHU Paimal Sharif 4,800 A A A A A A B B － A 1 1 1＜ 3＜ 1 9 BHU Pashoto 3,600 A A B C B B B B － A 1 1 1＜ 2＜ 1

10 BHU Sakkargah 4,800 D － － － － C B B － A － － － － － 11 BHU Rashang 7,200 A A A A A B B A － A 1 1 1＜ 2＜ 1

12 BHU Jhambairra 1,800 A A A A A B B C －－ 1 － － 1 3

13 BHU Gari Nawab Said 2,400 C C C C C B B B －－ － － － － －

14 BHU Shungli Payeen 6,000 A A A A A B B A －－ 1 － － 3 1

15 BHU Phagorra 6,000 C C C C C A B A －－ － － － － －

16 BHU Bhattian 3,600 A A A A A B B B － A 1 － － 3 1

17 BHU Jozz 4,800 A A A A A A B B －－ 1 － － 2 1

18 BHU Kannai 3,600 C C C C C B B B －－ － － － － －

19 BHU Bateela 2,400 D － － － － C B B － A － － － － －

20 BHU Kathorra 2,400 A A A A A B B B －－ 1 － － 3 1

21 BHU Kharrari 3,600 A A A A A A B B －－ 1 － － 2 1

22 BHU Khairabad 1,800 A A A A A A B C －－ 1 － － 2 1

23 BHU Saidra Blund Kot 3,000 A A A A A A B B －－ 1 － － 2 1

24 BHU Battley 1,800 C C C C C B B C －－ － － － － －

25 BHU Argashorri 4,200 C C C C C B B B －－ － － － － －

26 BHU Pomong 1,800 C C C C C B B C －－ － － － － －

27 BHU Battamorri 4,800 B A A A A A B B － C (1) － － (4) (1)

28 BHU Hutal Batkool 4,800 A A A A A A B B － A 1 － － 2 1

29 BHU Behari 1,200 A A A A A B B C －－ 1 － － － 2

30 BHU Roop Kanni 1,200 D － － － － C B C －－ － － － － －

31 BHU Tailous 3,600 A A A A A B B B －－ 1 － － 2 3

32 BHU Kuz Tandool 2,400 D － － － － C B B － A － － － － －

33 BHU Bracharr D － － － － C B －－－ － － － － －

34 BHU Charbagh 3,600 A A A A A A B B －－ 1 － － 3 1 Legend Recovery Priority Criteria for damage Criteria for outpatients Other criteria A: To be reconstructed Extensive damage, out of use: A 10,000/year or more: AA Lack of Doctors: B B: To be reconstructed if no duplication with Moderate damage, needs repair: 6,000-9,999/year: A Inappropriate Site: C other donors is confirmed B 2,000-5,999/year: B Under Other Donor’s Aid: C C: Excluded from the Project, due to slight Slightly damaged, no problems: C 1,999/year or less: C damage D: Excluded from the Project, since the existing conditions could not be confirmed.

－2-2－

(3) Selection of Facilities to be Reconstructed in the Project (Education Sector)

1) Criteria for selecting the facilities to be reconstructed in the Project

A screening of priority schools was carried out on the basis of the selection criteria on 412 schools requested by the Pakistan side: 363 primary schools, 25 middle schools, 22 high schools, one high secondary school and one boys’ degree college. Priority was given to a school that was in conditions as follows. • A school that required reconstruction due to heavy damage by the earthquake.

• A school that was accessible from a main road to the school for the transport of construction materials and equipment. • A school that had a certain enrollment and the necessary teachers. • A school with eligible land to reconstruct.

• A school with two classrooms or more before the earthquake.

• A school that had no duplication of assistance for reconstruction by other donors. • A school without any availability of alternative schools nearby to receive the proposed school students. • A school of which a site was owned by the provincial or state government. Based on the priorities above mentioned, the selection criteria were set up as follows.

－2-3－

Table 2.3: Criteria for Priority Schools to be Reconstructed in the Project No. Selection Items Decision Criteria Notes [Source1] Report on Rapid Assessment Survey of A Collapsed or heavily damaged Government Schools in Earthquake Affected (1) Extent of damage District of NWFP (surveyed by School Mapping nd C Slightly damaged Consultants),17 Nov., 2005 (2 edition) [Source2] Field Survey by the study team A Accessible by car [Source 1] Road Restriction Information by Pakistan Army Operation Room in Batagram B Accessible on foot or by donkey Camp as of the End of February, 2006 Not accessible due to road (2) Accessibility [Source 2] Field Survey by the study team restrictions or decision by School C [Source 3] School & Literacy Department of Monitors of School & Literacy Batagram district Department of Battagram district GPS and A 50 students or more [Source 1] List of Government Primary, Middle, Min. GGPS C Less than 50 students High and Higher Secondary Schools in District required Students GMS and A 75 students or more Battagram provided by Government of NWFP number ＊1) GGMS C Less than 75 students School & Literacy Department. (3) of GHS and A 100 students or more [Source 2] Education Statistics of School & students Literacy Department of Battagram District in GHSS C Less than 100 students and 2006 School year A 2 teachers or more teachers Teachers＊2) 2 teachers or more C Less than 2 teachers Flat and sufficient land area for [Source 1] Field survey by the study team A reconstruction Narrow land but possible for reconstruction by reducing the B (4) Present situation of existing sites number of classrooms in case of three classrooms or more

C Insufficient land for reconstruction

[Source 1] List of Proposed Schools attached to Number of existing classrooms A Tow classrooms or more "Reconstruction of damaged school buildings in (5) before the earthquake district Battagram, 19 Jan., 2006, Government of C Less than two classrooms NWFP School & Literacy Department". No duplication of assistance for A Duplicated [Source 1] Information from the Executive (6) school reconstruction by other District Officer of School & Literacy Department donors C Not available of Battagram District Availability of alternative schools [Source 1] Field survey by JICA Study Team A Not available (7) nearby to receive the proposed school students C Available Owned by provincial or state [Source 1] Information from School & Literacy A (8) Land ownership government Department of Battagram District C Owned by private citizens Remark *1: Number of students was 75 students/school. The numbers of schools with 75 students or more for which reconstruction was requested were equal to 35% of the total number of primary schools, 27% of middle schools, and 68% of high schools and high secondary schools. Therefore primary schools with 50 students or more were selected. The number of those primary schools was increased to approximately 60% of the total number of primary schools. Criteria for high schools and high secondary schools were increased to 100 students or more. Remark *2: Priority was given to a school that had two classrooms or more and two teachers or more before the earthquake.

2) Selected facilities to be reconstructed in the Project

It was very difficult to make a reconnaissance survey of all the schools for which reconstruction was requested due to a limited study period and difficult accessibility to the sites. Therefore, existing statistics data and site information given by the school & literacy department also were applied to evaluate the school selection items. If there was one or more selection items rated C, such a school was excluded from the Project. As a result, 118 schools were selected: 106 primary schools, three middle schools, seven high schools, one higher secondary school and one degree college.

－2-4－

Table 2.4: Summary of Priority Schools to be Reconstructed in the Project Number of Schools for Number of Priority Schools Type of School. Classification which reconstruction Allai Tehasil Battagram Tehasil Sub-Total was requested GPS 252 32 31 63 (1) Primary Schools GGPS 111 10 33 43 Sub-Total 363 42 64 106 GMS 17 1 1 2 (2) Middle Schools GGMS 801 1 Sub-Total 25 1 2 3 (3) High Schools and GHS 22 2 5 7 Higher Secondary GHSS 101 1 Schools Sub-Total 23 2 6 8 (4) Boys’ Degree College 101 1 Total 412 45 73 118

Major reasons not to be selected as a priority school were that the number of teachers was less than two teachers and the number of students was less than the nominally required number. The second reasons were insignificant damage and/or the inaccessibility to the school.

Table 2.5: Schools not to be selected and the Reasons Selection Criteria for not Selecting the Schools

Type of Schools private parties

f schools not selected not selected f schools o (1) Only Slightly Damaged by the Earthquake Earthquake the by Damaged Slightly Only (1) Accessible Not (2) required minimally for sufficient (3)Not teachers and students of number reconstruct to area land enough (4)Not of slope hilly and area insufficient an to due boundary land the (5) Under Classrooms 2 existed Earthquake the before of assistance (6)Duplicated donors other by reconstruction school (7) Available ofalternate schools students school proposed the receive to nearby (8)by Owned Number GPS 43 74 116 4 29 0 1 0 189 GGPS 30 12 43 1 3 0 0 0 68 GMS 52120000 015 GGMS 5070000 0 7 GHS 5080000 015 GHSS 0000000 00 Total 88 88 186 5 32 0 1 0 294 Note: Some of the schools were duplicated in different selection items.

(4) Selection of Facilities to be Reconstructed in the Project (Roads and Bridges)

1) Bridges

Based on the site survey, the study team selected the priority bridges to be reconstructed in the Project. Necessity of the reconstruction works was confirmed for all the seven bridges that were requested by the Pakistani government. However, the Project decided to focus on the bridges that will improve the accessibility to health and education facilities to be reconstructed in the Project. Therefore, three bridges, No. 3, No. 6, and No. 7 were selected as the priority bridges.

－2-5－

Table 2.6: Evaluation of Bridges for which reconstruction was requested Bridge Evaluation Pashuto Bridge • The superstructure was seriously damaged. Abutment structures were also unstable. Urgent (Bridge No.1) reconstruction was required to replace the damaged superstructure and the abutment. A new bridge with two traffic lanes will be favorable. • Bridge No. 1 will not improve the accessibility for the health and education facilities in the Project. Bridge No. 1 was therefore excluded from the Project. Rope Kanai Pedestrian Bridge • Superstructure collapsed completely due to the earthquake and the abutment structures were (Bridge No.2) seriously damaged. Those damaged structures hindered the access to the residential areas. Urgent reconstruction was required to replace the damaged superstructure and the abutment. • Bridge No. 2 will not improve the accessibility for the health and education facilities in the Project. Bridge No. 2 was therefore excluded from the Project. Banna Bridge • Bridge No. 3 was located at a main road in the Allai Tehasil in the Battagram district and near (Bridge No.3) the urbanized areas. • The bridge was located on the main road in Allai and bore relatively large traffic volume. The bridge had a narrow road width of one traffic lane. • The superstructure had been damaged by floating logs and flood due to the insufficient clearance above the high water level of the river. The abutment was damaged due to the earthquake. A new bridged should be designed to secure the freeboard above the high water level. • Urgent reconstruction was required to replace the damaged superstructure and the abutment. A new bridge with two traffic lanes was favorable. Besham Bridge • Bridge No. 4 completely collapsed. A temporary embankment was constructed to allow the (Bridge No.4) passage of road traffic. • In the next rainy season, the temporary embankment will be eroded and out of use. Urgent reconstruction was required to replace the damaged superstructure and abutment. A new bridge with two traffic lanes was favorable. • The bridge will not improve the accessibility for the health and education facilities in the Project. Therefore, the bridge was excluded from the Project. Shumlai Bridge • An old bridge was damaged by the earthquake. Vehicles forded the river at shallow places that (Bridge No.5) will be flooded and closed in the rainy season. Urgent reconstruction of the bridge was required. A new bridge with two traffic lanes was favorable. • Bridge No. 5 will not improve the accessibility for the health and education facilities in the Project. Therefore, bridge No. 5 was excluded from the Project. Battagram College Bridge • Bridge No. 6 was damaged by the earthquake. The damage to the bridge was still progressing. (Bridge No.6） Therefore, the urgent reconstruction was required by the installation of a new bridge having the same road width of the existing bridge of one traffic lane. Banna Bridge • The foundation works had been completed before the earthquake and were then affected by (Bridge No.7) the earthquake. The recommencement of the construction was not decided yet. Urgent reconstruction of the bridge was required. • An old bridge was located 300 m upstream from bridge No. 7. The river width at the old bridge was narrower and more appropriate for construction than the site of bridge No. 7. Therefore, the new bridge was recommended to be located at the site of the old bridge.

2) Roads

Roads for which reconstruction was requested by the Pakistani government were located in the mountainous areas and the areas that had a hazardous nature due to landslides and slope failures. Before the earthquake, there were frequent slope failures caused by rainfall. The hazards of the landslides and slope failures seemed to be made worse by the earthquake. In addition to those hazardous natures, the road width of the seven main access roads was limited to two traffic lanes and in some places to one traffic lane, due to hilly topographic conditions.

Therefore, extensive slope protection will be required to secure the safe and stable traffic ways. The extensive slope protection means that the reconstruction of the requested roads requires a very long

－2-6－ construction period and will entail very high construction costs. On the other hand, the Project needed to be completed within a short time. Therefore, the requested roads were excluded from the priority infrastructure of the Project.

(5) Agreement with the Pakistani Side for the Selected Facilities to be Reconstructed in the Project

Based on the screening as mentioned above, the Pakistani side agreed with the contents of the selected facilities that will be reconstructed in the Project. In a response to this agreement, ERRA issued the letter that confirmed the contents of the Project as attached in the appendices.

2-2 OUTLINE DESIGN OF THE REQUESTED JAPANESE ASSISTANCE

2-2-1 Design Policy

(1) Basic Direction The Project will be implemented in accordance with the basic directions as follows.

• The Project will reconstruct damaged facilities; however, it will not rehabilitate facilities. • Damaged facilities will be reconstructed to be capable to serve the same function as they did pre-earthquake. Thus, future demand will not be taken into account in designing the scale of the facilities.

• Reconstruction works will be implemented at the same sites where the facilities were damaged and alternative sites were not considered.

(2) Natural Conditions Temperature fluctuates largely within a day and a year in the Battagram district. Small windows were recommended to protect from the strong sunshine in the summer and the cold weather in the winter. A ceiling height was designed to protect rooms from the radiant heat caused by the heated roofing. A construction schedule was planned to avoid the earthworks and foundation works in the rainy season from July to September. One of the most important things that caused the large scale of the disaster due to the earthquake was that the earthquake-resistant designs were not applied to most of the existing buildings. The Japanese standard for the earthquake-resistant design was applied to all the buildings of the Project to strengthen the earthquake resistance.

(3) Social Conditions A school in Battagram has employed a chowkidar (janitor) for crime prevention and cleaning. An iron-barred window was provided as an antitheft device in the principal’s room.

(4) Construction Materials The construction materials will be provided from domestic and imported products which will be available in the country. The project sites were located in mountainous areas. Therefore, the transport of the construction materials and equipment will be carried out by donkeys and human power.

－2-7－

(5) Practical Use of Local Contractors

Public works in Battagram district have been carried out by local contractors which have been selected from the registered companies. The local companies did not have adequate capacity in terms of the business scale and quality management to implement the construction works of the Project. Therefore, the contractor will be selected through a pre-qualification process and from the large-scaled companies in Islamabad, Peshawar, and other large cities.

(6) Operation and Maintenance

Durable and weather-resistant construction materials were selected to ease the operation and maintenance works.

(7) Type of Materials and Equipment

Simple and durable finishing and materials were selected to ease the repair and maintenance works.

(8) Construction Methods and Construction Schedule

Construction methods commonly practiced by the local contractors were selected. Strict quality management will be required for the reinforcement bar arrangement. The construction schedule was planned to be appropriate to the limitations imposed by the rainy season.

(9) Procurement of Equipment Directions for procurement of equipment were mentioned in each relevant sector.

(10) Health Sector ERRA issued a basic policy for the reconstruction of the earthquake-affected facilities in the health sector. The policy was named “Build back better, Health Sector”. Then, ERRA issued a design policy for each type of health facility in accordance with the basic policy.

1) District headquarters (DHQ) hospital A regulation was issued to classify the type of health facilities in 2001. In accordance with the regulation, type C was selected for the DHQ based on the existing and future population within the service range of the hospital.

Table 2.7: Classification of Health Facilities Category Number of beds Number of specialist departments A 350 beds 16 + surgery/internal medicine 2 units B 210 beds 16 *2 C 110 beds 10 *1 D 40 beds Internal medicine, surgery, pediatrics, obstetrics and gynecology *1: Surgery, internal medicine, obstetrics and gynecology, ophthalmology, radiology, clinical laboratory test, dentistry, ENT, and orthopedic surgery *2: *1 plus anesthesiology, heart internal medicine, heart surgeon, physical medicine, plastic surgery, reconstructive surgery

ERRA worked out a basic policy to upgrade the DHQ to type B having a ward of 200 beds. However the new building reconstructed by the Japanese side had the main objective of restoring the affected

－2-8－ building to the pre-earthquake level. The DHQ was designed to permit future expansion in view of the fact that it will be upgraded to a hospital of type B by the Pakistani side.

The DHQ was being expanded as the central hospital for secondary medical service in the Battagram district. Hence, the plan was designed to cope with future extension/reconstruction of facilities to meet modifications in medical technology in the future. As was the entire hospital, the plan was made practical to meet the requirements of the local medical system.

2) Rural health center (RHC), Banna

On the basis of the standard drawings of the Pakistani side, a facility will be constructed to satisfy the needs of the medical services that were specified by ERRA. This facility is a core hospital in Allai Tehasil, and in the future it is planned to be upgraded from a rural health center to the Tehasil Headquarters hospital in accordance with the basic policy of ERRA, and it will be expanded in terms of facilities and organization in the future. The Project will reconstruct the facility to the level of rural health center having a 20-bed ward, and the portion of the facility to be extended to become a 40-bed ward in the future was being handled by the Pakistani side. The plan was such that future extension or reconstruction will be possible.

3) Civil hospital (CH), Thakot The existing ward portion had not been utilized before the earthquake and the damage due to the earthquake was minor. Thus, the portion to be restored was only the outpatient treatment portion, which was seriously damaged, and the plan was to add the rooms for family planning and pharmaceutical dispensary to the basic plan of the basic health unit (BHU).

4) Basic health unit (BHU) On the basis of the standard drawings of the Pakistani side, facilities were designed to satisfy the needs of the medical services that were specified by ERRA. Each basic health unit was a minimum basic unit having waiting rooms, a consultation room, a Woman’s Health Visitor’s room, and a vaccination (EPI) room. Depending on the size of the site of each basic health unit, the rooms for family planning and pharmaceutical dispensing were added on the basis of the plan of the minimum basic unit. The precondition for expanding the facilities was that the Pakistani side guaranteed to employ the required personnel.

5) Medical equipment Medical equipment will be provided as follows:

• The Project will provide medical equipment equivalent to that which was damaged by the earthquake and which can be operated by the existing medical staffs. (The Project will provide the equipment for an intensive care unit, an ENT, and an orthopedics unit of which construction had been started before the earthquake. Because the provincial government had approved the costs to employ the medical staffs for the equipment under construction.)

• Type of medical equipment will be of the orthopedics operation equipment that can be handled by general surgeons, the ENT diagnosis treatment equipment that can be used by ordinary doctors, the ventilators that can be used by internists, and the ICU related equipment.

• Electrical medical equipment will not be provided for any basic health units which were not －2-9－

connected to a stable power supply.

• Electrical medical equipment will be provided with automatic voltage regulators to avoid equipment troubles due to voltage fluctuation.

(11) Education Sector

1) Degree college and high secondary school In addition to the above, the contents of facilities were designed to keep the project cost within the project budget. Religious facilities were excluded from the Project.

2) Educational equipment The Project will provide the furniture for classrooms and the principal’s rooms.

Students in the primary schools have been used to attending classes in which the students sat on the floors. However, chairs and tables for students will be provided for the middle schools or higher. A set of one chair and table for each student will be easily used for different types of classes, such as group works. This single type of chairs and tables was adopted for the Project. Chairs and tables for teachers will be provided for all the schools in the Project. Steel lockers with keys will be provided for classrooms and principal’s rooms.

(12) Infrastructure sector (roads and bridges)

1) Determination of Width and Number of Lanes Width and number of lanes at the bridges was determined through discussions with the Works and Services Department, Battagram based on geometric design criteria of National Highway Authority and Government of NWFP.

2) Determination of the Bridge Location The bridges should be on the present location from the view point of recovery of the present conditions.

3) Determination of the Bridge Length The bridge length should be determined in order to ensure freeboard from the design high water level.

2-2-2 Basic Plan (Construction Plan/ Equipment Plan)

(1) Health sector

1) District headquarters Basic plans for the district headquarters (DHQ) was formulated as mentioned below.

Table 2.8: Basic Plan for DHQ (1/2) Existing building Building to be reconstructed (1) Medical treatment facility (seven buildings) All treatment facilities will be reconstructed. (ICU under construction will be completely reconstructed in the Project.) (2) Residential building Residences for doctor and staffs will be reconstructed after confirmation with the Government of NWFP.

－2-10－

Table 2.8: Basic Plan for DHQ (2/2) Item Description Site plan • The project site has been divided into two portions, the south and north sites astride the Karakoram highway. Main medical facilities have been located at the south site, while residential facilities for medical staffs have been located at the north site. • After the earthquake, a temporary medical facility was constructed at the north site to recommence the medical services. To restart the full medical services, the main medical facilities were planned at the south site. • The south site did not have adequate land area to expand the hospital in the future. Therefore, the MCHC and TBC were planned at places which did not obstruct the medical services at the temporary medical facility in the north site. • Facilities have not been well-coordinated to provide the proper functional linkage due to frequent expansions and reconstruction. Circulation within the facilities has been congested and parking spaces have been inadequately provided. Residences for medical staffs have occupied a large portion of the site and hindered the functional arrangement of the buildings. • Future expansion has been planned to meet the requirements of the secondary medical facility, which has required a ward with 100-200 beds. As the medical technology progresses, future expansion would be required for the clinical laboratory test department and the outpatient department in which a lot of laboratory test equipment have been used. • To cope with such future expansions and changes, the comb-shaped type was applied for the building arrangement. The comb-shaped type was more preferable than the satellite type for the site with steep slopes and limited vacant spaces. Floor plan • An outpatient treatment building, first aid unit, and administration department were planned at places that were easily assessable for visitors, outpatients, and vehicles. Those facilities were planned near the Karakoram highway. The examination department and an inpatient ward were planned at places far from the noise source of the Karakoram highway. A vacant space for future expansion to type B with 100 beds was provided to the south of those buildings. • The progress of examination and treatment technologies will require a change in the types of rooms and increase the number of rooms in the treatment department. Expansion to type B will require the modification of the facilities especially for the image diagnosis department. Thus, the floor plan was designed to meet those future requirements. • Both the outpatient treatment department and the inpatient ward were divided into male and female sections in accordance with religious doctrine. • Equipment for providing meals for inpatients has not been constructed in the existing facilities. Attendants of the inpatients have served meals. Therefore, kitchens were designed for the reconstructed buildings. Section plan • Ceiling height was set at 2800mm for ordinary rooms, while the ceiling height of 3000mm was applied for the operating room and image diagnosis room. • Storey height was set at 4000mm. • Galvanized corrugated sheet with iron roofing on steel trusses was adopted for the roof structure. Since the temperature in the summer rises to 50°C, a concrete slab was designed for the ceiling to provide a void space between the roof and the ceiling. The void space encouraged the ventilation and lowered the temperature in the building. Circulation • There was a difference of 25 m in the land elevation between the south and north sides. The slope gradient was plan larger than 1/12, which is the maximum gradient for a wheel chair. Due to the conditions imposed by the surrounding roads and an adjacent school, it was not practical to make the flat land. • The circulation plan was prepared to meet the requirements for transport of patients, equipment, and disabled persons. An elevator and a pedestrian bridge were planned at the proper places. • The elevator has a disadvantage in that it can have an effect on the clinical laboratory test equipment such as the electroencephalograph. Therefore, the elevator was planned to be as far as possible from the clinical laboratory test room. Structural • A rigid-framed structure of reinforced concrete was adopted to cope with the future expansion and change of plan facilities. Structural walls were also designed. • In Pakistan, there was no earthquake-resistant structural standard. Therefore, the structural plan followed the requirements in the technical standards for reinforced concrete structures and the specifications for building construction in Japan. • Curtain walls were of the brick masonry type. To improve the earthquake resistance, the brick walls will be fixed by reinforcement bars which will be fixed to columns and beams.

－2-11－

Item Description Equipment • Aging of the architectural equipment for electricity, water supply, and sanitation was faster than that of plan structural membranes. In addition, the improvement of facilities and equipment resulted in an increase in demand for water and electricity. Expansion of building structures could be implemented without any suspension of medical services. However, the expansion of the architectural equipment was difficult to implement without any suspension of the 24-hour a day operation of the hospital. • Therefore, the architectural equipment plan has taken the future expansion into consideration. [Electrical equipment] • An in-house power generator was indispensable for the hospital because the power supply in Battagram was frequently interrupted and fluctuates. Therefore, the in-house power generation was designed to secure a back-up system for the power supply. • Electricity of high voltage was designed to be stepped down at the electricity room. Power demand of existing medical equipment was not large; however the power demand was set at 50Wm2 to meet the future demand increase due to the expansion and improvement. • A small generator for emergency power supply was designed exclusively for the operating room and ICU. • A generator exclusive for the elevator, emergency lamps, and receptacles was designed separately from the generator for the medical services. • Type B sockets were selected for the architectural equipment and the medical equipment. Sockets for the medical equipment were designed to be grounded in accordance with the technical requirements for the medical equipment. • Taking into consideration the existing illumination, the intensity of the illumination was designed as follows: 100 lx for stairways; 200 lx for corridors, a waiting room, and a visitor room; 400 lx for a consultation room, a meeting room, and an office; 1000 lx for an operating room. • Nurse call was adopted. [Air-conditioning equipment] • A partial air-conditioning system was adopted for an operating room, an ICU, wards, and a mortuary. [Water supply equipment] • A water tank of the fiber glass type was designed at a elevated place in the site. The water tank will be installed on a platform or embankment with a height of 7 m. Water will be distributed by gravity flow. • Medical facilities and residents will be equipped with sanitary equipment including sinks and toilets. • Water demand was set at 1000 L/day/bed to meet the demand of the future expansion. [Wastewater treatment equipment] • Collection pipes will be installed and connected to the wastewater treatment equipment that will be located at the lowest place in the site. • Capacity of the septic tank was designed to meet the demand, including the future expansion. The wastewater discharge rate was set on the basis of 20,000 outpatients/month, 150 health workers/day, and 300 inpatients and attendants/day. [Medical waste disposal equipment] • The capacity of an incinerator for medical waste disposal was designed to meet the demand, including the future expansion of the hospital. The designed capacity was set for a 300-bed hospital in accordance with the technical standard issued by WHO. [Medical gas supply] • The capacity of a small oxygen gas generator was set at 3.30 Nm3/h with a discharge pressure of 0.3MPa.

2) Banna Rural Health Center Basic plans for the Banna rural health center (Banna RHC) were formulated as mentioned below.

Table 2.9: Basic Plan for Banna RHC (1/2) Existing building Building to be reconstructed (1)Medical treatment facility (five buildings) All five buildings will be reconstructed in the Project. (2) Residence (eight buildings) All eight buildings will be reconstructed in the Project.

－2-12－

Table 2.9: Basic Plan for Banna RHC (2/2) Item Description Site plan • The site had a gradual slope rising from a front road to the far side of the site. This slope was less than 1/12 and therefore suitable for a wheel chair. • A mother and child health center and a mosque were planned for near the front road. At the far side of the site, residential facilities were arranged. The mosque is arranged on a portion near the entrance of the site. • Medical facilities will be divided into four blocks: a mother and child health center, a medical treatment block including an outpatient treatment building with test and examination sections, an image diagnosis department, and a ward. Those blocks were designed to form a comb-shaped plan to cope with the future expansion of the medical facilities. Existing residential areas that would require a rather large land area were reduced to provide the vacant land that would be necessary for the future expansion. Floor plan • Three components, the outpatient treatment building, the clinical laboratory test department, and the ward will be divided into three blocks and connected by corridors to cope with the future expansion. • A kitchen will be provided for attendants to provide meals to the inpatients. • A ramp suitable for a wheel chair will be provided from the front road to the outpatient treatment building. The other blocks will be interlinked by corridors with a gradual slope suitable for the wheel chairs. Equipment [Electrical equipment] plan • Electricity will be supplied at a low voltage. There will be no electric room in the RHC. • Electrical equipment was planned to allow the installment of the emergency power supply equipment in the future expansion. • An uninterruptible power supply system will be installed for the lighting in the operating room. • Receptacles will be of Type B. Receptacles for medical equipment will be the earth type in accordance with the standards for medical facilities. • Based on the existing conditions, the illumination was designed as follows: 200 lx for corridors, a waiting room, and a visitor room, 400 lx for a consultation room and an office, and 1000 lx for an operating room. • Nurse call will be installed. [Air-conditioning equipment] • A partial air-conditioning system will be adopted for an operating room, an ICU, wards, and a mortuary. [Water supply equipment] • Drinking water will be supplied from a city distribution system. • Sanitary equipment, including sinks and toilets will be installed in the medical rooms and residences with water service. [Wastewater collection equipment] • A storage tank will be installed in the site. Indoor and outdoor drain pipes will be connected to the storage tank. • Collecting pits for the outdoor pipes will be made of concrete. [Wastewater treatment equipment] • Indoor and outdoor pipes will be installed. • Wastewater treatment equipment will be installed near the front road. • Taking the future expansion into account, the capacity of the septic tank was decided to be capable to serve 5,000 outpatients/month, 30 health workers/day, and 100 inpatients and attendants/day. [Medical waste disposal equipment] • Medical waste incinerating equipment for a 300-bed hospital will be installed to cope with the future expansion and standards issued by WHO. [Medical gas supply] • A small oxygen gas generator with a capacity of 3.30Nm3/h and a discharge pressure of 0.3MPa will be installed. Section plan • Ceiling height will be 2,800 mm for ordinary rooms while it will be 3,000 mm for an operating room and an image diagnosis room. Structural • Buildings will be rigid-framed structures. Bearing walls will be made of reinforced concrete, while partition plan walls will be brick walls. Structural analysis will follow the structural standards in Japan. • The roof will be made with the galvanized corrugate sheet iron roofing supported by steel trusses. Since the temperature in the summer rises to 50°C, a concrete slab will be installed at the ceiling level to provide a void space between the roof and the ceiling. The void will encourage the ventilation and lower the temperature in the building.

－2-13－

3) Thakot civil hospital

Basic plans for the Thakot civil hospital (Thakot CH) were formulated as mentioned below.

Table 2.10: Basic Plan for Thakot CH (1/2) Existing building Building to be reconstructed (1) Outpatient treatment building The outpatient treatment building will be reconstructed in the Project. (2) Dental treatment building The dental treatment building will not be reconstructed because no doctor or medical technician had been assigned there before the earthquake and the building had been out of use. (3) X-ray room/test room The x-ray room and test room will be left as they are. (4) Wards The wards will be left as they are. (5) Residential building The residential building will be reconstructed in the Project.

Table 2.10: Basic Plan for Thakot CH (2/2) Item Description Site plan • An outpatient treatment building will be reconstructed at the same location as the existing building. A dental treatment building will be demolished because it will be dangerous to leave the damaged building as it is. Residential facilities will be reconstructed at the same location as the existing facilities. Floor plan • In the medical treatment building, the medicine department will be attached to the basic floor plan of the basic health unit. Equipment [Water supply equipment] plan • The water receiving tank of 1m3 will be of the type to withstand outside exposure and made with fiber glass. • The water receiving tank will be equipped with a pump. An elevated water tank will be placed on the roof of an outpatient treatment building. Drinking water will be supplied from the elevated tank by gravity flow. • Sanitary equipment including sinks and toilets will be installed at medical rooms and residences with water service. • The water receiving tank will be equipped with one water faucet to secure continuous water supply in case of a power failure. [Wastewater collection equipment] • An osmotic cell will be installed within the site. Indoor and outdoor drain piping will be connected to the osmotic cell. • The osmotic cell with a cover will be made with a concrete frame. • Collecting pits for the outdoor piping will be made of concrete. [Wastewater treatment equipment] • Indoor and outdoor sewage piping will be installed. • A septic tank will be installed and connected with the indoor and outdoor piping. • An inlet will be made of concrete. The septic tank will be connected to the osmotic cell. [Medical waste disposal equipment] • A box made of bricks with 1 m square shape and 1.2 m depth will be installed underground. The medical wastes will be dumped into the box. The wall height will be 1m above the ground. Section plan • Ceiling height will be 2800mm for ordinary rooms. Structural • The roof will be made with galvanized corrugated sheet iron roofing supported by steel trusses. Since the plan temperature in the summer rises to 50°C, a concrete slab will be installed at the ceiling level to provide a void space between the roof and the ceiling. The void will encourage the ventilation and lower the temperature in the building. • The buildings will be rigid-framed structures. Structural analysis will follow the structural standards in Japan. Curtain walls will be made of bricks.

4) Basic health unit (BHU) Basic plans for the basic health units (BHU) were formulated as mentioned below.

－2-14－

Table 2.11: Basic Plan for BHU(at Behari) (1/3) Existing building Building to be reconstructed (1) Outpatient treatment building Damaged buildings will be reconstructed in the Project. (2) Ward Damaged buildings will not be reconstructed in the Project, because no doctor had been arranged before the earthquake. (3) Doctor residences Damaged buildings will not be reconstructed in the Project, because no doctor had been arranged before the earthquake. (4) Staff residences Damaged buildings will be reconstructed in the Project. (5) Guard residences Damaged buildings will be reconstructed in the Project.

Table 2.11: Basic Plan for BHU (at Other Locations) (2/3) Existing building Building to be reconstructed (1) Outpatient treatment building Damaged buildings will be reconstructed in the Project. (2) Doctor residences Damaged buildings will not be reconstructed in the Project, because no doctor had been arranged before the earthquake. (3) Staff residences Damaged buildings will be reconstructed in the Project. (4) Guard residences Damaged buildings will be reconstructed in the Project. Note: This includes BHU Jhambairra, BHU Shungli Payeen, BHU Bhattian, BHU Jozz, BHU Kathorra, BHU Kharrari, BHU Khairabad, BHU Saidra Blund Kot, BHU Hutal Batkool, BHU Tailous, and BHU Charbagh

Table 2.11: Basic Plan for BHU (3/3) Item Description Site plan • There is no room to rearrange outpatient treatment buildings or residential buildings at most of the sites for 13 basic health units (BHU). Therefore, new buildings will be reconstructed at the same location as the existing buildings. Floor plan • The medical treatment facility will consist of three rooms: an outpatient treatment room for male patients, an LHV’s (Lady’s Health Visitor) room for examining pregnant women and children, and a vaccination (EPI) room for vaccinations and storage of the equipment. The medical treatment facility will be attached to the male/female waiting rooms and toilets. Those rooms above mentioned will form the minimum basic unit. In case of rather large sites, the minimum basic unit will be attached to a pharmacy and a family plan room. Equipment [Electrical equipment] plan • The receptacles will be of Type B. Receptacles for medical equipment will be the earth type in accordance with the standards for medical facilities. • The wiring will be installed in an exterior wall of the building and then fixed to a plastic junction box at the exterior wall. [Water supply equipment] • A water receiving tank of 1m3 will be of the type to withstand exterior exposure and made with fiber glass. • The water receiving tank will be equipped with a pump. An elevated water tank will be placed on the roof of an outpatient treatment building. Drinking water will be supplied from the elevated tank by gravity flow. • Sanitary equipment including sinks and toilets will be installed in medical rooms and residences with water service. • The water receiving tank will be equipped with one water faucet to secure continuous water supply in case of a power failure. [Wastewater collection equipment] • An osmotic cell will be installed within the site. Indoor and outdoor drain piping will be connected to the osmotic cell. • The osmotic cell with a cover will be made with a concrete frame. • Collecting pits for the outdoor piping will be made of concrete. [Wastewater treatment equipment] • Indoor and outdoor sewage piping will be installed. • A septic tank will be installed and connected with the indoor and outdoor piping. • An inlet will be made of concrete. The septic tank will be connected to the osmotic cell. [Medical waste disposal equipment] • A box made of bricks with 1 m square shape and 1.2 m depth will be installed underground. The medical wastes will be dumped into the box. The wall height will be 1m above the ground. Section plan • The roof will be made of galvanized corrugated sheet iron roofing supported by steel trusses. Since the temperature in the summer rises to 50°C, a concrete slab will be installed at the ceiling level to provide a void space between the roof and the ceiling. The void will encourage the ventilation and lower the temperature in the building. Structural • The buildings will be rigid-framed structures. Structural analysis will follow the structural standards in Japan. Curtain walls plan will be made of bricks.

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5) Facility planning for the residential facilities

Residential facilities will be provided to stabilize the working conditions of the health workers. Contents of the residential facilities will be different in keeping with the positions of the medical experts as presented in the table below. The design concept for the equipment and structures will be similar to the basic health units.

Table 2.12: Residential Facilities according to the Positions of the Health Workers Position Residential Position Details of residential facility class type Special Doctor 1 Type 1 Lounge, 3 bedrooms, kitchen, toilet, shower room Medical Officer Medical Technician Dispenser LHV (Lady Health Visitor) 3 Technician Type 2 2 bedrooms, kitchen, toilet, shower room X-ray Technician EPI Technician Laboratory Technician Laboratory Assistant Dai (TBA) 4 Type 2 1 bedroom, kitchen, toilet, shower room Chaukidar Sweeper

6) Equipment Plan Specifications for the main medical equipment were as follows.

Table 2.13: Specifications for the Main Medical Equipment No. Equipment name Specifications 2 Anesthesia machine Vaporizer: halothane, isoflurane, with ventilator for anesthetizing Capacity: 400L or more 3-1 High pressure boiling sterilizer Sterilizing temperature: 120°C or higher Accessories: recorder, cart Ceiling installation type Operating light 36 Main light: 8 lamps or more, illuminance 135,000 or higher (Ceiling installation type) Auxiliary light: 5 lamps or more, illuminance 100,000 or higher Vessel: one vessel type 50 X-Ray equipment accessories Rating: 150KV, 500mA or more Bucky table, standing bucky Number of measuring items: 18 76 Blood calculator, automatic Capacity: 50 specimens/hour or more Specimen volume: full blood 50 uL or less System: pressure-controlled type or volume-controlled type 98 Critical care ventilator for adults Ventilation amount per cycle: 200 to 2,000 m or more System: pressure-controlled type or volume-controlled type 100 Critical care ventilator for infants Ventilation amount per cycle: 10 to 990 m or more Focus size: 10um or less 120 YAG laser Aiming beam: diode laser with electric stand

Main medical equipment to be installed at the DHQ was specified as follows.

－2-16－

Table 2.14: Main Medical Equipment for Department in the DHQ No. Department Main Equipment 1 Surgical Ward Pulse oxymeter, Suction machine, Bed Medical OPD Diagnostic set 2 Medical Ward Pulse oxymeter, ECG monitor, ECG, Infusion pump ob/GY Ward Pulse oxymeter, Infusion pump, Bed 3 Ob/Gy OPD Fetal Doppler , Education set for family planning 4 Pediatric Ward Pulse oxymeter, Phototherapy unit Eye OT Operating light, Operating table, YAG laser 5 Eye OPD Ophthalmometer Eye Ward Bed 6 Casualty Minor surgery set , Defibrillator, ECG 7 Pharmacy Laboratory refrigerator, Refrigerator OT No.1 Defibrillator, Operating light, Patient monitor 8 OT No.2 Operating light, Operating table Labor Room Bed for obstetric, Fetus monitor Sterilization High pressure boiling sterilizer, High speed sterilizer 9 Radiology X-ray equipment Suction unit, Ventilator , 10 ICU/CCU ICU bed, Syringe pump, Infusion pump 11 Pathology Spectrophotometer, ELISA microplate reader 12 Mortuary Autopsy table, Autopsy tool set 13 Dental Clinic Dental set 14 Laundry Laundry, Extractor, Iron ENT OPD ENT unit, Diagnostic set 15 ENT Ward Pulse oxymeter Orthopedic OPD Plaster splinting table 16 Orthopedic Ward Pulse oxymeter, Suction machine, Bed 17 TB Control Office Microscope 18 Maintenance Oscilloscope 19 Referral cases (Ambulance) Suction unit (mobile), Incubator

(2) Education sector

1) Site Plan

Most primary schools have been located in small sites. Classroom buildings were built to the fullest extent of the flat areas of the sites. Therefore, classroom buildings to be reconstructed in the Project will be placed at the same location as the existing buildings, due to the limited flat areas. Even though retaining walls will be constructed at the slopes, the available flat land will not be enough to expand or relocate the existing buildings.

2) Architectural plan

i) Size of classrooms and latrines

Among the schools for which reconstruction was requested by the Pakistani government, the largest number of classrooms was six for primary schools, three for middle schools, ten for high schools and 13 for higher secondary schools. The number of classrooms to be reconstructed in the Project will be the same as the number of previously existing classrooms. In cases where the project site was too narrow to reconstruct the same number of classroom buildings as the previously existing classrooms and/or the number of teachers was inadequate, the number of classrooms to be reconstructed was reduced.

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The outline design study team formulated standard types of classroom buildings, of which the number of classrooms varied from two to five. The number of reconstructed classrooms was adjusted by the combination of the different types of classroom buildings.

The number of latrine booths was decided based on the number of the reconstructed classrooms. A latrine of the one booth type was planned for a school with two classrooms, while a latrine of the two booth type was designed for a school with three or four classrooms. A latrine of the three booth type was attached to a school with five classrooms or more. A school with nine classrooms or more was provided with a latrine of the four booth type. ii) Floor planning

The North Western Frontier Province (NWFP) and Earthquake Rehabilitation & Reconstruction Authority (ERRA) have proposed different types of standard school buildings. Neither proposed standard type has been officially approved yet. The NWFP expected the outline design study team to propose earthquake-resistant school buildings.

Classroom buildings The dimensions of the existing classrooms have been classified into two different types: a 25 feet x 16 feet type (approximately 7.6 m x 4.9 m) and a 24 feet x 20 feet type (approximately 7.3 m x 6.1 m). According to the department of school & literacy in NWFP, the standard number of students in a classroom has been set at 40 students per classroom. The dimensions of the 16 feet classroom type have been a little small for the 40 students. In a school with two classrooms, the 16 feet classrooms have been placed to form an L-shape and connected by a verandah. On the other hand, the 20 feet classrooms have been placed straight along a verandah as a linear type. A principal’s room and a store room have been placed at the edge of the classroom buildings.

The outline design study team formulated eight different types of classroom buildings. Type A classroom building was formed in the L-shape. The 16 feet classroom type was applied to the type A. No principal’s room or storage room were provided for the type A. The 20 feet classroom type was applied to four classroom types from type B to type E. The classrooms of these four types were placed along a verandah in linear form. The other three types from type F to type H were designed for the narrow sites. The 16 feet classroom type was applied to these three types.

A principal’s room and storage room were attached to a classroom building with three classrooms or more. The width of the principal’s room was set at 3 m. The storage room was placed behind the principal’s room.

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Table 2.15: Types of Classroom Buildings Code Type of Classroom Dimension and Floor Area Type of Classroom Note Building (m2) A L shaped 2 classroom 41ft x 25ft（≒12.5m x 7.6m） 25ft x 16ft This type applies to schools type （95.0m2） （≒7.6m x 4.9m） with 2 classrooms. B Linear 2 classroom type 48ft x 28ft（≒14.6m x 8.5m） 24ft x 20ft This type applies to a （124.1m2） （≒7.3m x 6.1m） combination with other types in a school with 5 classrooms or more. C Linear 3 classroom type 82ft x 28ft（≒24.9m x 8.5m） 24ft x 20ft incl. a principal’s room （211.6m2） （≒7.3m x 6.1m） and a store room D Linear 4 classroom type 106ft x 28ft（≒32.2m x 8.5m） 24ft x 20ft incl. a principal’s room （273.7m2） （≒7.3m x 6.1m） and a store room E Linear 5 classroom type 130ft x 28ft（≒39.5m x 8.5m） 24ft x 20ft incl. a principal’s room （335.7m2） （≒7.3m x 6.1m） and a store room F Narrow depth and linear 50ft x 24ft（≒15.2m x 7.3m） 25ft x 16ft This type will be applied in a 2 classroom type （110.9m2） （≒7.6m x 4.9m） site with narrow depth of land. G Narrow depth and linear 85ft x 24ft（≒25.8m x 7.3m） 25ft x 16ft ditto 3 classroom type incl. a （188.3m2） （≒7.6m x 4.9m） principal’s room and a store room H Narrow depth and linear 110ft x 24ft（≒33.4m x 7.3m） 25ft x 16ft ditto 4 classroom type incl. a （243.8m2） （≒7.6m x 4.9m） principal’s room and a store room

Laboratory A laboratory was designed for high schools and higher secondary schools. The dimensions of the laboratory were set at 24 feet x 20 feet. A preparatory room and a store room were placed adjacent to the laboratory.

Latrine The layout of the existing latrines has been classified into two different types: a latrine inside a classroom building and a latrine separated from a classroom building. The separated type was adopted in the Project, taking the issues of stench and hygiene into account. A Turkish toilet of a soil water pit and a soak pit was chosen for the latrines. The dimensions of the latrines were formulated as follows.

Table 2.16: Dimensions of Latrines Mark Type of Latrine Dimension and Floor Area Note 1 1 booth for a school with 2 4’8” x 5’5” A soak pit 4’8” x 3’6” (approximately 1.4m x 1.1m) classrooms (approximately 1.4m x 1.7m) is installed away from the latrine building. The area (1.9m2) of the soak pit does not include the floor area of the latrine building. 2 2 booths for a school with 4’8” x 5’5” A soak pit 9’4” x 3’6” (approximately 2.8m x 1.1m) 3-4 classrooms (approximately 2.8m x 1.7m) is installed away from the latrine building. The area (4.7m2) of the soak pit does not include the floor area of latrine building. 3 3 booths for a school with 14’ x 5’5” A soak pit 14’ x 3’6” (approximately 4.3m x 1.1m) is 5-8 classrooms (approximately 4.3m x 1.7m) installed away from the latrine building. The area of (7.3m2) the soak pit does not include 4,’8” x 5’5” (approximately 1.4m x 1.7m) (1.9m2) the floor area of latrine building. 4 booths for a school with 9 Two latrines of 2 booths each will be applied to a classrooms or more school with 3-4 classrooms. －2-19－

iii) Section Planning All the buildings will be single storied type. A section plan was formulated as follows.

• A ceiling will be installed to reduce the radiant heat in summer and the noise of rain. The ceiling height will be 3 m and a ventilation hatch will installed in the ceiling. • Roofing will be a pitched and trussed roof. The trusses will be made of steel. • Distance from wall to eaves will be 0.6 m.

• Floors will be made of concrete with steel trowel finishing. Walls will be of laid brick with paint finishing. Windows will be of wooden frame. iv) Structure planning

Anchorage of reinforcing bars into concrete of a beam and a column has been insufficient in most o Anchorage of reinforcing bars into the concrete of the beams and columns has been insufficient in most of the existing school buildings, so that the beams and columns have not been structurally rigid. Therefore, there are many buildings the beams and columns of which were damaged and separated because the parts of beam and column could not resist deformation by the earthquake. There is no standard for structural calculations to handle such a big earthquake in Pakistan. Consequently Japanese structural design standards were applied to the Project.

• Structural frame: The load-bearing capacity of the soil was estimated at five ton per square meter. The substructures will be reinforced concrete wall footings. The floors will be of concrete with steel trowel finishing and a rigid frame of reinforced concrete will compose the wall foundations, columns and beams.

• Design load: The Coefficient of standard shearing stress of 0.2 described in a Japanese architectural standard law was applied as a seismic load. • Strength of materials: Design strength of the reinforced concrete is 21N/mm2. v) Electric installation planning Electric power was to be provided for a school only when electricity had previously been provided to the school or where an electric line had already been run to the school site.

• Lighting fixtures: Fluorescent fixtures were planned taking maintenance and economy into consideration.

• Receptacle outlet fixtures: A receptacle outlet was planned in rooms that required electric power. Available power was 3 phase and 230 V. The number of receptacle outlets was planned at one set per classroom, one set per principal’s room and two sets per laboratory. vi) Water supply planning

Water supply plumbing fixtures were planned for a school only when water service had previously existed at the school. In such cases water pipes will be installed to connect to the latrines.

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vii) Construction material plan

Construction materials for the Project were selected taking locally available construction materials and methods into consideration.

Table 2.17: Planned construction methods Part The Project Local Construction Method Reasons to be selected

Foundation Reinforced concrete Reinforced concrete Locally available

Floor Concrete Concrete ditto

Walls Brick work Stone work, Brick work ditto Structure Columns and Reinforced concrete Reinforced concrete ditto beams Steel trusses with corrugated Steel trusses with corrugated galvanized iron sheets, wooden Roof ditto galvanized iron sheets trusses with corrugated galvanized iron sheets Exterior Mortar with paint finish Mortar with paint finish ditto walls Exterior Concrete with steel trowel finish Concrete with steel trowel finish ditto Exterior slabs finish Wooden windows with paint Wooden windows with paint Windows ditto finish finish Wooden doors with paint finish, Doors Wooden doors with paint finish ditto Steel doors with paint finish Floors Concrete with steel trowel finish Concrete with steel trowel finish ditto

Interior finish Walls Mortar with paint finish Mortar with paint finish ditto

Ceiling Ceiling boards with paint finish Ceiling boards with paint finish ditto

3) Equipment plan Furniture for classrooms and the principal’s rooms will be provided in the Project.

• One set consisting of a chair and a desk for a teacher will be provided for every classroom and principal’s room.

• Chairs and desks for students will be provided for middle schools and higher. Forty sets of chairs and desks will be provided for every classroom to serve the standard number of students per classroom at 40 persons. Rugs will be provided for primary schools.

• One set of steel lockers will be provided for every classroom and principal’s room.

－2-21－

Table 2.18: Furniture Plan Room Furniture Quantity per room Total Quantity 20 pieces 245 classrooms x 20 pieces/classroom = 4,900 Rugs (1 piece/2 pupils) pieces Classrooms of a A set consisting of a desk and 1 set 245 classrooms x 1 set/classroom = 245 sets primary school chair for a teacher Steel locker 1 unit 245 classrooms x 1 unit/classroom = 245 units Classrooms of a A set consisting of a desk and 40 sets 66 classrooms x 40 sets/classroom = 2,640 sets middle school, chair for a student high school, and A set consisting of a desk and 1 set 66 classrooms x 1 set/classroom = 66 sets higher chair for a teacher secondary Steel lockers 1 unit 66 classrooms x 1 set/classroom = 66 sets school A set consisting of a desk and 1 set 30 classrooms x 1 set/classroom = 30 sets Principal’s room chair for a teacher Steel lockers 1 unit 30 classrooms x 1 set/classroom = 30 sets

4) Basic plan for boys degree college and high secondary school

Basic plans for the boys degree college and high secondary school were formulated as mentioned below.

Table 2.19: Basic Plan for Boys Degree College and High Secondary School Item Boys Degree College High Secondary School 1) Facility Plan The project will reconstruct the academic block The project will reconstruct classrooms, including the classroom building and the computer labo., examination hall, technical administrative building. The number of labo., administrative office, toilets, and guard classroom will be adjusted to the number of office. existing teachers. The computer laboratory and the physics and tech. laboratory will be attached to the academic block. 2) Site Plan Building will be placed on the same location A classroom building will be formed by two with the existing buildings to protect from stories to secure the places for SADC. The flood. buildings will be placed on the same location with the existing buildings. 3) Floor Planning Size of facilities such as classrooms, physics Size of facilities such as classrooms, physics and tech. laboratory, computer laboratory, and tech. laboratory, computer laboratory, library, administrative offices, halls, latrines, library, administrative offices, halls, latrines, and corridors will be designed based on the size and corridors will be designed based on the size of existing facilities and the girls degree college of existing facilities. that was under construction. A courtyard will be arranged in the site. 4) Section Planning Buildings will be formed by two stories. Buildings will be formed by two stories. Roofing will be a trussed roof that will be made Roofing will be a trussed roof that will be made of steel. of steel. 5) Structure Planning A rigid frame of reinforced concrete will A rigid frame of reinforced concrete will compose the wall foundations, columns and compose the wall foundations, columns and beams. Walls will be made of bricks and will beams. Walls will be made of bricks and will not be structural walls. not be structural walls. Structural calculation will be examined in Structural calculation will be examined in accordance with Japanese structural design accordance with Japanese structural design standards. standards. 6) Electrical Installation and Receptacle outlets will be placed in rooms that Receptacle outlets will be placed in rooms that Water Supply Planning will require electric power. Drinking water will will require electric power. Drinking water will be supplied from an existing elevated tank. be supplied from an existing elevated tank. Sanitary equipment will be installed in toilets Sanitary equipment will be installed in toilets and bathrooms. Wastewater will be discharged and bathrooms. Wastewater will be discharged into septic tanks. into septic tanks.

－2-22－

(3) Bridges

1) Consistency with design standards

Existing bridges have been formed with a narrow width for one traffic lane. Taking into account the increased traffic demand due to the future expansion of the urbanized areas, the width of the bridges will be widened for all the bridges except the Battagram College bridge (No. 6). The Battagram College bride will be on a drive from a main road to the college, therefore the one traffic lane will be sufficient for the traffic demand in the future.

2) High water level Based on the information from local residents and the department of roads, Battagram District, the high water level was decided for the Banna bridge (No. 3) and Battagram College bridge (No. 6).

3) Location and length Location for the three bridges in the Project will be same as the existing bridges.

4) Type of bridges

• Abutments: Pile foundations were applied to the Banna bridge (No. 3) and the Battagram college bridge (No. 6) to prevent scouring.

• Superstructures: Reinforced concrete structure was applied to the Battagram College bridge (No. 6) taking the length of the bridge and economic aspects into account. Pre-cast concrete type was applied to bridges No. 3 and No. 7.

5) Access road to the bridges Designed elevation of the Banna bridge (No. 3) was raised by 3 m from the elevation of the existing bridge to secure adequate clearance from the high water level in the river. Therefore, an access road was required at both ends of the bridge for the length of 100 m.

2-2-3 Outline Design Drawing Basic design drawings for the bridges and health and education facilities are shown in the annex 1 to 3.

2-2-4 Implementation Plan

2-2-4-1 Implementation Policy

(1) Directions for construction The Project will cover the scope of works as follows.

• Civil works including debris removal, land preparation, drainage, and foundation works, • Building construction for hospitals, schools, and residential units, and

• Civil works for the bridges.

To implement the Project effectively and efficiently, there will be several issues to be addressed as follows. －2-23－

• A part of the construction works, including construction supervision, will be carried out by the Pakistani government. Those works for which the Pakistani side is responsible will need to be coordinated with the related works in the Project. The Pakistani side will need to arrange the required budget and staffs.

• Hospitals and schools in the Project will be mainly small scale buildings of one story. The Project will need to be completed in a short construction period and divided into a series of contract packages. Therefore, the use of local contractors was recommended.

(2) Directions for procurement The procurement policy was made as follows.

• Medical equipment using electricity (especially battery-operated ones) will be limited to Japanese products or some products of third countries, in consideration of durability and its resistance for voltage fluctuation.

• Of the medical equipment using electricity, products made in China will be allowable for consumables such as operating lamps that need to be constantly replaced. Because the costs can be easily afforded.

• Medical furniture and beds that will not directly influence the accuracy of medical diagnosis or treatment will be procured from local products. The policy as to the provision period for consumables will be as follows.

• In Battagram district, the department in charge of ordering consumables is busy with arranging medical records because the confusion after the disaster still remains. For this reason, consumables will be provided for one year in consideration of quick startup of operations after delivery of the equipment.

2-2-4-2 Implementation Conditions

(1) Safety management The project sites are located in hilly areas and have limited land areas with difficult accessibility. Safety management will be an important issue in the construction works. Before the construction begins, work groups will have coordination meetings to prepare the work schedules. In addition to the coordination meetings, hazard signs and security fences will be installed to make the work spaces more safe and efficient.

(2) Work coordination Various kinds of construction works will be carried out in the project sites. The construction works will include demolition of existing facilities, land preparation, building and civil works, water supply and sanitation works, and electric works. Therefore, more than two subcontractors will simultaneously work in the sites. The management capability of the contractor will be fundamental to secure the quality of the facilities. Precautions will be taken to prevent early commencement of the building works before the completion of land preparation and foundation works.

－2-24－

Contractors and consultants will confirm the responsibilities and schedules of construction works to clarify the safe work conditions and quality control. The work schedules will be prepared based on the coordination between the related works to make the construction works more efficient and effective.

(3) Securing the work space

Project sites are located in hilly areas and have the small land areas, which will be insufficient to secure the spaces for a temporary office, a stock yard, and construction roads. In case of small project sites, alternative sites for work spaces in adjacent areas will need to be used temporarily upon prior agreement with the owners and neighborhoods.

(4) Direction for climate and social conditions

Precipitation in the rainy season from July to September is in a range from 150 to 200 mm/month. Construction schedules need to be prepared so as to prevent delays due to the rainfall.

Every year, Pakistan has a fasting period for approximately 35 days (Ramadhan) in the Islamic calendar. The workmanship and speed of procurement will be lowered in the fasting period. Therefore, the construction schedule needs to take the Ramadhan period and Eid ul-Fitr festival into account.

(5) Direction for the project period and construction method The construction schedules will be planned to avoid construction methods unsuitable in the rainy season. The construction methods will basically follow the local practices. Quality control will be carried out, especially for fixing the reinforcement bars. The contractors were classified into four categories as presented in the table below.

Table 2.20: Qualification for Tenderers Class Contract Amount Required Number of Engineers A More than Rs. 10.0 million 2 engineers or more B Rs.10.0 million or less 2 engineers or more C Rs.5.0 million or less No requirements D Rs.2.5 million or less No requirements

According to the Battagram district office of the ministry of public works, the construction companies in the Battagram district were limited to companies in class C and D. Those companies had the capability to construct a basic health unit. The construction companies in class A will be recommended to secure the work schedule and workmanship in the Project. Among the class A companies, the capability thereof were different considering the number of engineers and construction equipment. Therefore, pre-qualification will be recommended to select the candidates for the tenders. Criteria in the pre-qualification will include the following items. • Number of engineers, • Number of vehicles to transport the materials and equipment, and

• Number of pieces of equipment to control the quality of concrete including pot mixers and vibrators.

－2-25－

(6) Direction for procurement of materials and equipment

Construction materials will be both local and imported. Due to the hilly topography, the access to the project sites will be difficult for vehicles. Therefore, the transportation will be carried out by donkeys and manpower. The project sites will be widely dispersed in the district. The required number of donkeys and workers will need to be estimated for the demolition works and land grading works that will be conducted in the early stage of the Project.

Since the medical equipment will be produced on an order basis, a period of four months will be required from ordering to completion of manufacturing. For the procurement of the first shipment urgently required for reconstruction, the delivery time will be set at 0.5 months.

2-2-4-3 Scope of Works Responsibilities of Japanese and Pakistani sides were examined as mentioned in the table below.

Table 2.21: Responsibilities of Japanese and Pakistani sides Japan Pakistan • Compilation of tender and contract documents, • Securing of the site necessary for construction and executions of consulting service of (The offer of the keeping first machine parts place construction management etc. in the DHQ site is included). • Construction of medical facilities, educational • Amendment of construction in the building etc. facilities, and bridges shown by the Outline when meeting obstacles. Design • Provision of public services such as water supply • Construction of outdoor facilities shown by the and electricity to be constructed to the building Outline Design, and site. • Granting of medical treatment equipments shown • Transfer of machine parts used in temporary by outline design. housing hospital.

Contents of the Project will be divided into nine packages as presented in the table below. Demarcation of the packages was examined based on the type of facilities, the location of the project sites, and the priority of the facilities. The Pakistan government will relocate existing equipment that is currently being used in the temporary health facilities.

Table 2.22: Scope of Works by Package Package Description Package 1 • Schools (permanent structures with high priority) Package 2 • DHQ (temporary structure for urgent rehabilitation) Package 3 • DHQ (permanent structure) Package 4 • Banna RHC Package 5 • Thakot CH • BHUs, schools, and bridges in the Battagram Tehasil Package 6 • BHUs, schools, and bridges in the Allai Tehasil Package 7 • Boys Degree College • High secondary schools Package 8 • Medical equipment for DHQ, Banna RHC, and BHUs Package 9 • Four BHUs upgraded to RHC

－2-26－

2-2-4-4 Consultant Supervision

(1) General

The government of Pakistan and Japan International Cooperation System (JICS) will conclude an exchange of notes (E/N). Minutes of meeting (MOM) will be attached to the E/N and signed by both authorities. The MOM will specify the contents of the Project based on the result of the Outline Design Study. After the signing of the E/N, A non-project grant aid will be commenced for the Project. A consultant company will conclude a contract for consulting service with JICS. The scope of works of the consulting service will be specified in the E/N. The consultant company will be responsible for the items listed below in the tender and construction supervision. • To prepare tender documents and references that will be suitable for construction works,

• To demarcate the Project into contract packages effective and suitable for implementation,

• To secure the safety and the environmental and social issues. Japanes e S ide Exchange Pakistani Side of Note (E/N) Ministry of Finance ERRA Agent Order of Agreement Order of Project Project Execution Execution

JICS Contract for NWFP and Battagram Construction Contract for Consultancy Service Schedule Managemen Consultant t Contructor Construction Management Contract for Supervision for Procurement Procurement

Equipment Manufacturer

Figure 2.1: Structure of Project Execution (2) Contents of consulting services

1) Tender process

• After the public announcement, the consultants will distribute the tender documents and explain the contents of the Project.

• The consultants and JICS will jointly evaluate the tender documents submitted by tenderers in

－2-27－

Islamabad.

• The consultants will assist in issuing an award for the successful tenderer.

• After the approval of an evaluation report by JICS, the consultant will assist in preparing the contract with the successful tenderer.

• The consultant will request the participation of the Pakistani government to implement the Project.

2) Construction supervision • The consultants will explain design drawings and technical specifications.

• The consultants will review and approve the drawings submitted by the contractor.

• The consultants will assign a residential engineer for the construction supervision at the project site. • The consultants will report the result of tests for facilities, materials, and equipment. • The consultants will verify the materials, experts, and topographic survey. • The consultants and JICS will settle any trouble or problems caused in the Project. • The consultants will instruct the contractor so as to follow the work schedule. • The consultants will report the work progress and other necessary information to JICS.

• The consultants will issue the certificates that will be required for the payment to the contractor.

3) Procurement and installment of equipment

• The contractor will propose the types of the autoclave, x-ray apparatus, and medical equipment for dentistry and otolaryngology. The consultants will confirm the proposed medical equipment with the design drawings and instruct the contractor to revise, if necessary, the proposal.

• The manufacturer will carry out the tests of the medical equipment. The consultants will inspect the manufacturer’s tests.

• If any defects are revealed in the manufacturer’s tests, the consultants will confirm the results of the tests and instruct the manufacturer regarding the method for rectification. • The consultants will issue a test report prior to shipping.

• The consultants will confirm stock yards and installation sites. They will supervise the installation works and the acceptance procedures.

4) Defect liability

• The consultants will issue a completion certificate and assist in the processes of the taking over. Then, the consultants will prepare a completion report.

• The consultants will support the inspection and repair works after the completion of construction works.

－2-28－

(3) Assignment schedule of consultants

The consultant team will be headed by a project manager who have experience with similar projects and understand the contents of the Project. The consultant team will be formed of experts who have the experience with tenders, design reviews, and construction supervision. The project manager will assign a representative expert for each contract package.

Table 2.23: Scope of Works by the Consultant Position Scope of Works Project Manager • To supervise the work progress and work schedule of the Project. • To instruct and advise the team members. • To coordinate between JICS and the embassy of Japan. Team Member for Package 1 & 2 • To support a public announcement and a tender evaluation. • To attend the contract negotiation with the successful tenderer. • To review the drawings submitted by the contractor and approve the drawings. • To supervise the construction works at the site. Team Member for Package3& 4 ditto Team Member for Package 5 ditto Team Member for Package 6 ditto Team Member for Package 7 ditto Team Member for Package 8 • To support a public announcement and a tender evaluation. • To attend the contract negotiation with the successful tenderer. • To supervise and inspect the installment works of the medical equipment. Medical Expert • Two Japanese experts and two experts for procurement will supervise the procurement works. • To coordinate installation of the medical equipment. • To verify the operation and maintenance after the installation works and training. • To inspect the manufacturer’s test of the products made in Japan and third countries.

2-2-4-5 Quality Control Plan

(1) Civil and building works

1) Review and approval of construction drawings The contractor shall submit the design drawings, structural drawings, and construction drawings for approval to the consultants. The consultants will review and approve the submitted drawings.

2) Material tests The consultants will test the construction materials. The material tests will be carried out at the sites and places appropriate for the supplier and manufacturer.

(2) Health sector Chinese products will be procured if the products are manufactured under good quality control. For the ISO 9001 quality management system in China, the audit standards of the examination institute are very low in comparison with those of Europe, America and Japan. Its reliability is low, therefore only the models having acquired the CE marking will be procured.

As to the quality assurance of local products, it is necessary to divide the medical furniture and the medical instruments. Many of the medical furniture manufacturers are manufacturing at factories having received the ISO9001 quality management system certification. As to their individual products, however, they have not obtained the CE marking because their market is mainly the domestic market. On the other

－2-29－ hand, the manufacturers of medical instruments are exporting their products and have obtained the certification (CE marking) for the individual products. Under such circumstances, the furniture products having the ISO9001 certification and the medical instruments having the CE marking shall be procured.

As to the products made in third countries such as Germany and Japan, there is no quality control problem because adequate domestic laws are in place.

2-2-4-6 Procurement Plan

(1) Building and civil works

Construction equipment will be arranged from domestic sources, while the medical equipment will be provided from Japan. The imported equipment will be unloaded at the Karachi port and transported to the site.

• The Pakistani government will support the tax exemption for customs clearance and be responsible for customs procedures.

• Access roads capable for transport will be limited to the urbanized areas and trunk roads. Therefore, the construction equipment will be transported to the sites by donkeys which are commonly used in the project areas.

(2) Procurement (health sector)

1) Current practices for procurement of medical equipment Products such as medical furniture, medical instruments, ENT treatment tables, and suction units, excluding advanced electronic medical equipment, are mainly manufactured in the Islamic Republic of Pakistan. Recently such manufacturers have obtained the ISO9001 quality management system certificate and are exporting their products to Europe. As to the advanced electronic medical equipment including imaging equipment such as ultrasound and X-ray equipment, anesthesia apparatus, ventilators, electrocardiograms, and patient monitoring equipment, products imported from Europe, America and Japan are widely used. The recent trend is that products made in China are selected because of the lower prices of the equipment and lower prices of the consumables.

2) Considerations for procurement of medical equipment As to ordinary medical equipment, with the precondition of a certain level of quality assurance, products made in Pakistan can be procured in consideration of economic efficiency. As to the medical electronic equipment, the procurement is from Japan or third countries because of the diagnosis system and durability. As to the consumables and equipment requiring parts for periodical replacement, Chinese products can be procured. Supplier countries of the main equipment are shown belwo.

－2-30－

Table 2.24: Supplier Countries of Main Equipment Code. Equipment name Supplier Pakistan Japan Third countries 2 Anesthesia machine with ventilator z z 3-1 High pressure boiling sterilizer z z 9 Pulse oxy-meter z z 12 Defibrillator z z 18 Electrocardiogram (ECG) z z 20 ENT unit z z 30 Microscope z z 36 Operating light (Ceiling installation type) z z 37 Operating table z z 39 Patient monitor z z 65 Fetus monitor z z 66 High pressure sterilizer z z 69 Apparatus for cataract & glaucoma operations z z z 76 Blood cell counter, automated z z 86 Spectrophotometer z z 91 ECG monitor z z 93 Sigmoidoscopes for adults and infants z z 96 ELISA microplate reader z z 98 Ventilators for adults z z 100 Ventilators for infants z z 120 YAG laser z z 127 Portable ventilator z z

2-2-4-7 Operation Guidance Plan

As to the equipment to be provided to DHQ and TBCO, the unpacking, installation, trial operation, operation, and explanation on operation and maintenance will be the responsibility of the suppliers. The equipment to be provided to CH, RHC, BHU, and MCHC do not use electricity and do not require special installation or trial operation, but it is difficult to make an opportunity for the health care professionals in the prefecture to gather at one place, and so the unpacking, installation, guidance on operation, and explanation of operation and maintenance methods shall be executed at each facility by the suppliers.

2-2-4-8 Implementation Schedule The project period was estimated at 25 months from the signing of the E/N to the completion of construction works. The implementation schedule was formulated as shown in the figure below.

－2-31－

Months Package Structure 12345678910111213141516171819202122232425

1 Schools (Urgent Schemes)

2 DHQ (Pre-Fabrication)

3 DHQ (Batagram)

4 RHC (Banna)

C.H. (Thakot) BHU (Batagram) 5 School (Batagram) Bridge (Batagram) BHU (Allai) School (Allai) 6 Bridge (Allai) Bridge (Allai)

7 Boys Degree College Higher Secondary School

BHN (Building and equipment) BHU (Equipment only) 8 RHC (Banna) Equipm't CH (Thakot) DHQ Hospital BHU (4 nos)

Other BHU (Enlargement)

D/D Pre-Qualification and Tender Construction Figure 2.2: Implementation Schedule

Since much of the medical equipment will be produced on an order basis, the period to manufacture the equipment for DHQ was scheduled at four months. The inspection before shipping was scheduled at half a month. Ten-ton trucks will transport the equipment from Karachi to Islamabad, but from Islamabad to Battagram, only 8-ton trucks will be usable because the Karakoram Highway becomes narrow in width. Based on those conditions, the required periods were estimated at 1.3 months for sea transport and 0.7 months for inland transport. Most of the BHUs are located at inconvenient places; therefore the required periods were estimated at one day for unpacking/installation at each BHU. The total period for the unpacking/installation was estimated at one month.

－2-32－

Month Work Items 12345678910 Discussion with construction side Discussion with supplier Preparation of equipment fabrication drawing Manufacturing of equipment Product (factory) inspection Inspection before shipping Equipment checking before shipping Shipping Equipment transportation Unpacking, carrying-in, installation Adjustment/trial operation Initial operation guidance Acceptance, completion delivery Figure 2.3: Procurement Implementation Processes (Proposal)

2-3 OBLIGATIONS OF RECIPIENT COUNTRY The Pakistani government will be responsible for the following items to implement the Project.

• To arrange the customs clearance of imported products at the Karachi port.

• To arrange the approval by relevant organizations required for the implementation of the Project (including the procedures for environmental and social considerations). • To permit Japanese and third country experts related to the Project to enter the country. • To arrange the tax exemption for the imported and domestic products. • To arrange the sites required for the Project (including a temporary place in the DHQ).

• To secure the safety of experts, materials, and facilities related to the Project and protect them from vandalism.

• To install the terminal points of public utilities, which include water supply, telecommunications, and power supply.

• To arrange the budget required for operation and maintenance of the facilities and equipment to be provided in the Project as well as for medical staffs (ENT, orthopedics, and ICU) and technical staff (paramedical).

• To arrange the consumables/replacement parts required for maintenance of the facilities/equipment

• To relocate the equipment currently used at the temporary hospital. Professional engineers will be required to move the X-ray equipment. The relocation work will be done as soon as possible after the budget allocation (about 1 million to 1.2 million yen) to be facilitated by discussions between the installers and the provincial government. 2-4 PROJECT OPERATION PLAN

(1) Health sector

To operate and maintain the medical equipment, the Pakistani government will need to establish an operation and maintenance system. The requirements for the O&M system will not be limited to employ －2-33－ adequate and capable experts but also to prepare the O&M manuals. The O&M system will also need to be capable to report institutionally the record of accidents, inventories, and maintenance.

The sub-workshop of Abbottabad has controlled five districts including Battagram. The periodic checking of medical equipment and troubleshooting have been conducted on an on-call basis. A chief engineer has been assigned at the central workshop in the Pshawar/Khyber educational medical institute. His guidance will be given when unspecified failure occurs in the equipment. Repair reports on all the problems encountered with the equipment will be submitted to the chief engineer, and the activities of each workshop will be reported to the major planning officer.

The personnel of the sub-workshop have the technical capabilities to cope with a wide range of repair work from replacement of X-ray tubes to oil filling for suction units if replacement parts necessary are available.

Major Planning Officer

Chief Engineer Central Workshop

Sub-workshop, Sub-workshop 2 Sub-workshop 3 Abbottabad

Figure 2.4: Organization Chart of Maintenance/Control Workshop

Table 2.25: Position and Education Level of Personnel of Abbottabad Sub-Workshop Position Number of persons Education level Engineer 3 persons Degree obtained (2 persons) Honorary degree of electrical engineering (1 person) Mechanic 1 person Degree obtained

(2) Education sector

1) Procedure for operation and maintenance There are two different procedures for operation and maintenance as mentioned below.

i) Procedure for heavily damaged facilities

• The literacy & education department of the Battagram district will request that the public works department of the district provide a site survey and cost estimation.

• The public works department will request that the development planning department of the NWFP via the literacy & education department provide a budget allocation.

• The development planning department will approve the submitted cost estimation and arrange a

－2-34－

budget for the public works department. The development planning department will submit requests to the public works department for repair works. • The public works will carry out the repair works.

ii) Procedure for slightly damaged facilities

• A school will submit a request for repair work to the development planning section, the literacy & education department, the Battagram district.

• The development planning section will survey the damage to the facilities and confirm the request submitted by the school.

• The development planning section will approve the request and deposit an amount of 1,760 Rs/classroom to the bank account of the school. • The school will carry out the repair work.

2) Role of PTA A PTA has been formed by teachers and parents of the students in the school. The PTA has held monthly meetings and submitted the minutes of meeting to the department of literacy and education under the Battagram district. The PTA has operated and maintained the school and monitored activities in the school.

3) Records of operation and maintenance Operation and maintenance cost has been set at 1,760 Rs/classroom. The O&M cost has been called the PTA fund. Records of the O&M costs in FY2004 are as follows.

• Primary school: 1,550,500Rs for 868 classrooms of boys’ schools and 735,000Rs for 420 classrooms of girls’ schools.

• Middle school: 138,250Rs for 79 classrooms of boys’ schools and 103,750Rs for 52 classrooms of girls’ schools. • High schools: 28,165Rs for 131 classrooms for boys’ schools. There have been funds for the O&M cost other than the PTA fund. The funds have consisted of the president’s program with an amount of 3 million Rs and the educational renovation program with an amount of 7 million Rs. Most of these funds have been used to purchase equipment and conduct training and the literacy education for adults. Budget for the O&M cost has been limited.

(3) Bridges The works and services department of the Battagram district will be responsible for the operation and maintenance of three bridges to be reconstructed in the project. The operation and maintenance works will consist of items mentioned below.

1) Inspection and maintenance to be carried out every year • To clean the sediment in the drainage,

• To weed shoulder and slope along the access roads, and

－2-35－

• To inspect and repair the bank protection after the flood.

2) Inspection and maintenance to be carried out every five and ten years • To overlay the road surface treatment. • To replace and repair the expansion joints. 2-5 PROJECT COST ESTIMATION

2-5-1 Initial Cost Estimation

The initial cost for the Project was estimated at 3.1 billion yen. Based on the conditions for the cost estimation mentioned in section (3) below, the initial costs by the Japanese side and the Pakistani side were estimated as follows. Those estimated costs were not defined as the amount of the grant aid, which would be specified in the E/N.

(1) Initial cost estimation taken care of by the Japanese side Initial cost estimation: 3.093 million yen Battagram District, 19 medical facilities, 118 education facilities, and 3 bridges Package Facility Q’ty Initial Cost (unit) (million yen) PACKAGE 1 General Items 1 L.S. 8 GPS/GGPS 6 no. 210 Sub-total 218 PACKAGE 2 Pre-fabricated OPD 1 no. 39 (Contract amount) Sub-total 39 PACKAGE 3 General Items 1 L.S. 10 Main Building 1 no. 415 MCHC 1 no. 15 OPD 1 no. 59 Casualty 1 no. 34 Mortuary 1 no. 4 TB control center 1 no. 14 EDO office 1 no. 52 Sub-total 603 PACKAGE 4 General Items 1 L.S. 6 Main hospital 1 no. 71 Generator room 1 no. 9 Elevated water tank 1 no. 6 Mortuary 1 no. 3 Residence Type I 4 no. 28 Residence Type II 5 no. 31 Residence Type III 2 no. 9 Outdoor works 1 no. 2 Sub-total 165 PACKAGE 5 General Items 1 L.S. 28 Thakot Civil Hospital 1 no. 6 Basic Health Unit, 12G5S 6 nos. 53 Basic Health Unit, 12G7S 3 nos. 35 Residence Type I 10 nos. 70 Residence Type II 14 nos. 86 Residence Type III 10 nos. 44 School Type A 53 nos. 267 School Type B 5 nos. 27 School Type C 11 nos. 103 School Type D 1 no. 11 School Type E 3 nos. 40 School Type F 1 no. 5 School Type H 1 no. 10 Sub-total 785 PACKAGE 6 General Items 1 L.S. 19 Basic Health Unit, Original 2 nos. 10 －2-36－

Package Facility Q’ty Initial Cost (unit) (million yen) PACKAGE 6 Basic Health Unit, 12G5S 1 no. 9 Basic Health Unit, 12G7S 1 no. 12 Residence Type I 4 nos. 28 Residence Type II 4 nos. 25 Residence Type III 4 nos. 17 School Type A 30 nos. 151 School Type B 2 nos. 11 School Type C 9 nos. 84 School Type D 2 nos. 22 School Type G 2 nos. 17 Bridge No. 3 1 no. 29 Bridge No. 7 1 no. 21 Sub-total 455 PACKAGE 7 General items 1 no. 3 Battagram higher secondary school Classroom 1 no. 16 Computer laboratory 1 no. 16 Examination hall 1 no. 41 Physics and tech. laboratory 1 no. 16 Administration block 1 no. 17 Boys degree college Classroom 1 no. 186 Hostel (rehabilitation) 1 no. 72 Bridge No. 6 1 no. 14 Sub-total 381 Package 8 General Items 1 no. Medical Equipment etc. 1 no. 157 Sub-total 157 Total 2,803

Construction supervision, and technical training 290 million yen

(2) Initial cost taken care of by the Pakistani side

• Relocation of existing x-ray apparatus and cost for commissioning test: 0.6 million Rs (1.2 million yen)

(3) Conditions for initial cost estimation i) Time of cost estimation: March, 2006 ii) Exchange rate: 1$ = 117.19 yen 1Rs = 2.11 yen

iii) Duration of the Project: The Project will be implemented in one phase. The periods of detailed design and equipment procurement were formulated as shown in the implementation schedule. iv) Others: The cost estimation was carried out in accordance with the regulations of the grant aid scheme system of the Government of Japan.

2-5-2 Operation and Maintenance Cost

(1) Health sector

1) Maintenance budget The budget for the operation and maintenance of equipment and facilities has been as presented in the table below. Costs for repairing and maintenance have been as shown in the table below. The costs

－2-37－ combine those for both facilities and equipment. Repair works for the equipment have been carried out by a sub-workshop under the Ministry of Health free of charge. All the costs, except for periodic parts replacement, have been paid as the maintenance costs of the facility.

Table 2.26: Operation Budgets of Medical Facilities Item DHQ RHC BHU MCHC Rupee Yen Rupee Yen Rupee Yen Rupee Yen Cost of repairing and 135,000 ¥284,850 10,000 ¥21,100 79,413 ¥167,561 0 ¥0 maintenance control Source: Executive District Office Note: Exchange rate at 1 Rs = 2.11 yen

Since the Project will reconstruct the damaged facilities and equipment, the equipment to be provided in the Project will exclude the equipment that was still in operation. The Project will not cause any increase of costs for operation and maintenance.

2) Issues to be addressed for operation and maintenance Delivery of periodic replacement parts will take time and the malfunctioned equipment will be left as it is for long time. The staff of the sub-workshop will need to arrive at the site within one or two days after receiving information of the trouble by telephone. He will investigate the cause of the trouble and report to the director. If the budget from the district is sufficient, the sub-workshop will immediately start the procedure for procurement. However, the budget allocation will be done every three months after approval of the annual budget. Therefore, the procurement will often take time. As a flexible arrangement, it will be recommended that they deposit the diagnosis fees and then utilize the deposits to purchase the periodic replacement parts.

(2) Education sector The Project will aim to reconstruct the affected facilities. Therefore, the Project will not require additional costs for operation and maintenance. However, the study team confirmed that there were schools that did not have an adequate number of teachers or budget for operation and maintenance before the earthquake. During the implementation of the Project, the Pakistani government will need to confirm the availability of teachers and budget related to the Project.

(3) Bridges The operation and maintenance costs will be required as mentioned in the table below.

Table 2.27: Operation and Maintenance Costs for Bridges to be Reconstructed Item Frequency Parts to be Inspected Scope of Works Estimated Cost (Rupee) Drainage Two times per year Road surface drainage To replace sediments 2,200 Access road Two times per year Shoulder and slope To weed along shoulder 31,200 and slope Bank protection After flood Bank protection along To repair the parts 61,700 river damaged by flood Road pavement One time per five years Road surface treatment To overlay the road 453,100 surface treatment Expansion joint One time per ten years Expansion joint To replace and repair 18,500 the expansion joint

－2-38－

2-6 OTHER RELEVANT ISSUES There are several issued to be addressed in order to implement the Project efficiently and effectively.

• The Pakistani government will carry out the works for which it is responsible without any delays.

• The building work for the orthopedics, ENT, and ICU had been in progress under SAC (structural adjustment credit) before the earthquake. Under the SAC, it had been planned that the infrastructure improvement, personnel arrangement, and equipment provision would be sequentially made, but the earthquake occurred during the infrastructure improvement. Presently there is no doctor in charge of the units at DHQ. A CPO (chief planning officer) of Department of Health, Government of NWFP confirmed that the department will secure the personnel during the construction phase, but it will be necessary to obtain a definite promise on this point from the Pakistani government.

• Check with the Department of Health, Government of NWFP to ascertain if it has plans for a budget of the same amount or higher than the amount in fiscal 2005.

－2-39－

CHAPTER 3

PROJECT EVALUATION AND RECOMMENDATIONS CHAPTER 3 PROJECT EVALUATION AND RECOMMENDATIONS

3-1 PROJECT EFFECT Project effect was evaluated as follows.

(1) Health sector

Table 3.1: Project Effect in the Health Sector Existing Conditions Methods implemented Direct Effect Indirect Effect and Problems in the Project • Most of existing medical • The Outline Design Study • The functional recovery of • Improvement of maternal facilities in the Battagram was carried out and the referral system can be and infant mortality rates, Thesil and Allai Tehasil selected 19 medical promoted by recovering the health indexes of were damaged heavily or facilities to be functions of each facility. mothers/children partially by the earthquake reconstructed out of 34 • In villages, postnatal • Improvement of crude • The Pakistani government medical facilities that were examination, (safe death rate in Battagram provided first aid and requested by the Pakistani delivery), antenatal District through functional medical services for government for the examination, and (family recovery of referral system outpatients in temporary reconstruction. plan service) activities are facilities. However the • The Project will reconstruct recovered. reconstruction of the the selected 19 medical • In villages, simple surgical affected facilities was not facilities and provide treatment can be received. implemented yet. medical equipment. • In villages, ordinary diagnosis/prescription can be received. • In urban area (Battagram), X-ray diagnosis, clinical laboratory test, and diagnosis/treatment services by 8 specialists are restored.

(2) Education sector

Table 3.2: Project Effect in the Education Sector Existing Conditions Methods implemented Direct Effect Indirect Effect and Problems in the Project • Most of existing education • The Outline Design Study • The Project will provide the • Education level will be facilities in the Battagram was carried out and earthquake-resistant improved in the project Thesil and Allai Tehasil selected 118 education education facilities with area. were damaged heavily or facilities to be well-prepared environment partially by the earthquake reconstructed out of 411 for 13,887 students. • The reconstruction of the education facilities that • The Project will provide the affected facilities was not were requested by the work spaces and equipment implemented yet. Pakistani government for for principals and teachers the reconstruction. to improve the management • The Project will reconstruct of the schools. the selected 118 education facilities and provide equipment.

－3-1－

(3) Infrastructure sector (bridge)

Table 3.3: Project Effect in the Infrastructure Sector (bridge) Existing Conditions Methods implemented Direct Effect Indirect Effect and Problems in the Project • Bridges in the Battagram • The Outline Design Study • Accessibility to the schools • The Project will contribute Thesil and Allai Thesil were was carried out and and medical facilities that to the improvement of the damaged by the earthquake. selected three bridges to be will be reconstructed in the opportunity for education reconstructed out of seven Project will be improved. and medical services in the bridges and 21 roads that project area. were requested by the Pakistani government for the reconstruction. • The Project will reconstruct the selected three bridges.

3-2 RECOMMENDATIONS

(1) Health sector

To implement the Project effectively, the Pakistani government will be responsible for the issues mentioned below.

1) Securing health care professionals

To improve the medical services, it will be necessary not only to improve the hardware such as facilities and equipment but also secure health care professionals (doctors, nurses, X-ray technicians, pharmacists, etc.). Both improvements for hardware and software will be required to ensure proper and effective medical services. Especially to support the mother/child health care services at remote places, it will be necessary to secure nurses for public health and maternity at basic health units.

2) Strengthening operation/maintenance system and securing the budget It will be necessary to strengthen the operation and maintenance systems and secure proper budgets for increasing related costs. Part of the treatment fees will need to be allocated for procuring the maintenance parts, thus securing financially independent development.

3) Improving the infrastructure related to the project sites It will be necessary to improve the infrastructure including access road, electricity, communication, and water supply that will be related to the facilities of the Project.

(2) Education sector The Pakistan government will need to deal with the following challenges and recommendations to maintain continuously and effectively schools that will be reconstructed in the Project.

1) Appropriate deployment of teachers Teachers for the schools to be reconstructed in the Project will be employed by the departments of school & literacy and higher education in NWFP and Battagram district.

－3-2－

2) In-service teacher training

In-service teacher training will be carried out by the department of school & literacy in NWFP and Battagram district. The training will be highlighted to the quality improvement in the primary education and the education for girls, because a promotion rate from primary schools to middle schools in Battagram district have rated at the second lowest level in NWFP.

3) Proper maintenance of school infrastructures Departments of school & literacy and higher education in NWFP and Battagram district will prepare an annual budget for maintenance and operation. The departments of school & literacy and higher education in NWFP will prepare a maintenance manual on a building and equipment. The department will hold a seminar of school maintenance for stakeholders. Principals will reorganize school maintenance committees mainly formed by a local community and strengthen regular maintenance activities.

(3) Collaboration with other donors

In the health sector, international donors of WB, ADB, and WHO implemented the projects to improve the human resource, the medical equipment, and the infrastructure related to the medical facilities. The project sites were not duplicated with the sites of the Project. In the implementation of the Project, the consultants will need to confirm the activities of other donors with ERRA.

In the education sector, there was no NGO and donors which implemented the project in accordance with a mid-long term plan. In the implementation of the Project, the consultants will need to confirm the activities of other donors with ERRA.

－3-3－

APPENDICES

A.1 MEMBER LIST OF THE STUDY TEAM

1st Field Study Name Organization Position General Manager, Grant Aid Kazuo NAKAGAWA Management Department, Japan Team Leader International Cooperation Agency Grant Aid Management Department, Fuyuki SAGARA Project Coordinator Japan International Cooperation Agency Project Manager/ Planner for Yoshikimi INOUE Nippon Koei Co., Ltd. Reconstruction and Rehabilitation Atushi MORIOKA Nippon Koei Co., Ltd. Architect (Medical Facility) Masao OKUI Binko International Ltd. Architect (Medical Facility) Expert for Construction Planner (Medical Nobuyoshi FURUICHI Binko International Ltd. Facility) Yasuko ASANUMA Binko International Ltd. Expert for Medical Equipment Kyoichi SUGIYAMA Nippon Koei Co., Ltd. Architect (Education Facility) Expert for Construction Planner Nobuhiro KOIZUMI Nippon Koei Co., Ltd. (Education Facility) Takashi OGAWA Binko International Ltd. Cost Estimator (Medical Equipment) Ichiro ARAKI Nippon Koei Co., Ltd. Cost Estimator 1 (Facility) Masaru ISHIKAWA Nippon Koei Co., Ltd. Cost Estimator 2 (Facility) Shohei YAMAMOTO Nippon Koei Co., Ltd. Water Supply Engineer Hidenori OSUMI Nippon Koei Co., Ltd. Road and Bridge Engineer1 Ahmed MORGAN Nippon Koei Co., Ltd. Road and Bridge Engineer2

2nd Field Study Name Organization Position Project Manager/ Planner for Yoshikimi INOUE Nippon Koei Co., Ltd. Reconstruction and Rehabilitation Atushi MORIOKA Nippon Koei Co., Ltd. Architect (Medical Facility) Expert for Construction Planner (Medical Nobuyoshi FURUICHI Binko International Ltd. Facility) Yasuko ASANUMA Binko International Ltd. Expert for Medical Equipment Kyoichi SUGIYAMA Nippon Koei Co., Ltd. Architect (Education Facility) Expert for Construction Planner Nobuhiro KOIZUMI Nippon Koei Co., Ltd. (Education Facility) Gentaku GOTO Nippon Koei Co., Ltd. Coordinator

AP-1 3rd Field Study Name Organization Position Project Manager/ Planner for Yoshikimi INOUE Nippon Koei Co., Ltd. Reconstruction and Rehabilitation Atushi MORIOKA Nippon Koei Co., Ltd. Architect (Medical Facility) Expert for Construction Planner Nobuhiro KOIZUMI Nippon Koei Co., Ltd. (Education Facility) Gentaku GOTO Nippon Koei Co., Ltd. Coordinator

4th Field Study Name Organization Position Project Manager/ Planner for Yoshikimi INOUE Nippon Koei Co., Ltd. Reconstruction and Rehabilitation Atushi MORIOKA Nippon Koei Co., Ltd. Architect (Medical Facility) Expert for Construction Planner Nobuhiro KOIZUMI Nippon Koei Co., Ltd. (Education Facility) Masaru ISHIKAWA Nippon Koei Co., Ltd. Cost Estimator 2 (Facility) Gentaku GOTO Nippon Koei Co., Ltd. Coordinator

5th Field Study Name Organization Position Project Manager/ Planner for Yoshikimi INOUE Nippon Koei Co., Ltd. Reconstruction and Rehabilitation

AP-2 A.2 STUDY SCHEDULE

1st Field Survey [January 25 – March 3, 2006] No M/D Day Trip Stay Activity of the Wee k 1 1/25 Wed Tokyo to Islamabad Islamabad Move to Islamabad 2 1/26 Thu Islamabad to Battagram Battagram Site reconnaissance 3 1/27 Fri Battagram,Tokyo to Islamabad Battagram Site reconnaissance 4 1/28 Sat Battagram Battagram Site reconnaissance 5 1/29 Sun Battagram Battagram Site reconnaissance 6 1/30 Mon Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram, Peshawar 7 1/31 Tue Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 8 2/1 Wed Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 9 2/2 Thu Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 10 2/3 Fri Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 11 2/4 Sat Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 12 2/5 Sun Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 13 2/6 Mon Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 14 2/7 Tue Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 15 2/8 Wed Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 16 2/9 Thu Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, and meeting Battagram 17 2/10 Fri Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 18 2/11 Sat Islamabad, Battagram, Islamabad to Tokyo Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 19 2/12 Sun Islamabad, Battagram, Tokyo to Islamabad Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 20 2/13 Mon Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 21 2/14 Tue Islamabad, Battagram, Islamabad to Tokyo Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 22 2/15 Wed Islamabad, Battagram, Tokyo to Islamabad Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 23 2/16 Thu Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram, design works Peshawar 24 2/17 Fri Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram, design works Peshawar 25 2/18 Sat Islamabad, Battagram, Tokyo to Islamabad Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram, design works Peshawar 26 2/19 Sun Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 27 2/20 Mon Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 28 2/21 Tue Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram, design works Peshawar 29 2/22 Wed Islamabad, Battagram Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 30 2/23 Thu Islamabad, Battagram, Islamabad to Tokyo Islamabad, Site reconnaissance, filing of survey results, meeting, and Battagram design works 31 2/24 Fri Islamabad Islamabad, 1st C.C., meetings with the Pakistani governments, and Peshawar design works 32 2/25 Sat Islamabad Islamabad, Meetings with the Pakistani governments and design Peshawar works

AP-3 No M/D Day Trip Stay Activity of the Wee k 33 2/26 Sun Islamabad, Islamabad to Tokyo Islamabad Meetings with the Pakistani governments and design works 34 2/27 Mon Islamabad Islamabad Meetings with the Pakistani governments and design works 35 2/28 Tue Islamabad, Islamabad to Tokyo Islamabad Meetings with the Pakistani governments and design works 36 3/1 Wed Islamabad Islamabad Meetings with the Pakistani governments and design works 37 3/2 Thu Islamabad Islamabad Meetings with the Pakistani governments and design works 38 3/3 Fri Islamabad to Tokyo flying Move to Tokyo overnight

2nd Field Survey [March 29 – April 9, 2006]

No. M/D Day of Trip Stay Activity the Wee k 1 3/29 Wed Tokyo to Islamabad Islamabad Move to Islamabad 2 3/30 Thu Islamabad Islamabad Meeting with EOJ, WB, and Save the Children 3 4/1 Fri Islamabad Islamabad Filing of survey results and design works 4 4/2 Sat Islamabad Islamabad Filing of survey results and design works 5 4/3 Sun Islamabad Islamabad Filing of survey results and design works 6 4/4 Mon Islamabad Islamabad Preparation of materials for presentation 7 4/5 Tue Islamabad Islamabad 2nd C.C. 8 4/6 Wed Islamabad Islamabad Filing of survey results and design works 9 4/7 Thu Islamabad to Peshawar Peshawar Filing of survey results and design works 10 4/8 Fri Peshawar to Islamabad Islamabad Meeting with Peshawar Province 11 4/9 Sat Islamabad to Tokyo Flying Move to Tokyo overnight

3rd Field Survey [May 17 – June 1, 2006]

No. M/D Day of Trip Stay Activity the Wee k 1 5/17 Wed Tokyo to Islamabad Islamabad Move to Islamabad 2 5/18 Thu Islamabad Islamabad Filing of survey results and design works 3 5/19 Fri Islamabad Islamabad Meeting with EOJ, JICA, and JICS and design works 4 5/20 Sat Islamabad Islamabad Filing of survey results and design works 5 5/21 Sun Islamabad Islamabad Filing of survey results and design works 6 5/22 Mon Islamabad Islamabad Filing of survey results and design works 7 5/23 Tue Islamabad to Peshawar Islamabad, Meeting with the health department of NWFP and the Peshawar education department 8 5/24 Wed Islamabad Islamabad Filing of survey results and design works 9 5/25 Thu Islamabad Islamabad Filing of survey results and design works 10 5/26 Fri Islamabad to Peshawar Peshawar Move to Peshawar and meeting with local consultants 11 5/27 Sat Islamabad Islamabad Meeting with Dr. Afridi of the health department, NWFP 12 5/28 Sun Islamabad Islamabad Filing of survey results and design works 13 5/29 Mon Islamabad Islamabad Meeting with a representative in the education sector in the ERRA 14 5/30 Tue Islamabad Islamabad Meeting with a representative in the health sector in the ERRA 15 5/31 Wed Islamabad Islamabad Meeting with the JICA study team for master plan in the Muzaffarabad city 16 6/1 Thu Islamabad to Tokyo Flying Move to Tokyo overnight

AP-4

4th Field Survey [June 14 – June 29, 2006]

No. M/D Day of Trip Stay Activity the Wee k 1 6/14 Wed Tokyo to Islamabad Islamabad Move to Islamabad 2 6/15 Thu Islamabad Islamabad Meeting with JICA and JICS 3 6/16 Fri Islamabad Islamabad Meeting with EOJ and a representative in the health sector, ERRA 4 6/17 Sat Islamabad to Battagram Battagram Move to Battagram 5 6/18 Sun Battagram to Islamabad Islamabad Site reconnaissance at schools in Battagram, hospitals, and BHU upgraded to RHC 6 6/19 Mon Islamabad Islamabad Review of structural design for CH and BHU 7 6/20 Tue Islamabad Islamabad Initial cost estimation 8 6/21 Wed Islamabad Islamabad Meeting with JICA in regard to the initial cost estimation and meetings for the work progress of designs for college, higher secondary school, DHQ, and RHC 9 6/22 Thu Islamabad Islamabad Filing of survey results and design works 10 6/23 Fri Islamabad Islamabad Meeting with EOJ, JICA, and JICS 11 6/24 Sat Islamabad to Peshawar Peshawar Meeting with local consultants 12 6/25 Sun Islamabad Islamabad Filing of survey results and design works 13 6/26 Mon Islamabad Islamabad Filing of survey results and design works 14 6/27 Tue Islamabad Islamabad Filing of survey results and design works 15 6/28 Wed Islamabad Islamabad Filing of survey results and design works 16 6/29 Thu Islamabad to Tokyo Tokyo Move to Tokyo

5th Field Survey [July 5 – July 13, 2006]

No. M/D Day of Trip Stay Activity the Wee k 1 7/5 Wed Tokyo to Islamabad Islamabad Move to Islamabad 2 7/6 Thu Islamabad Islamabad Filing of survey results and design works 3 7/7 Fri Islamabad Islamabad Filing of survey results and design works 4 7/8 Sat Islamabad Islamabad Filing of survey results and design works 5 7/9 Sun Islamabad Islamabad Filing of survey results and design works 6 7/10 Mon Islamabad Islamabad Filing of survey results and design works 7 7/11 Tue Islamabad Islamabad Filing of survey results and design works 8 7/12 Wed Islamabad Islamabad Meeting with JICA 9 7/13 Thu Islamabad to Tokyo Islamabad Move to Tokyo

Note: ERRA - Earthquake Rehabilitation and Reconstruction Agency, PERRA - Provincial ERRA, CC - Consultative Committee, NWFP - North West Frontier Province, DHQ - District Headquarter, RHC - Rural Health Center, CH - Civil Hospital, BHU - Basic Human Unit

AP-5 A.3 LIST OF PARTIES CONCERNED IN THE RECIPIENT COUNTRY

Earthquake Reconstruction & Rehabilitation Authority (ERRA) Saleem Altaf Chairman General Nadeem Ahmed Deputy Chairman Dr. Mateer Ahmad Shaheen Prime Minister Secretariat, Health Sector Dr. Ameer Hussain Naqui Education Sector Dr. Saeed Ashraf Siddiqui Road & Transport Dr. Awais Manzur SUMRA Education, Water Supply & Social Sector

National Engineering Services Pakistan (Pvt.) Limited (NESPAK) Tahir Shamshad General Manager of Islamabad Office

Provincial Earthquake Reconstruction and Rehabilitation Authority (PERRA) Mr. Jan Shed Ul - Hasan Director General

Government of NWFP Dr. Abdul Hameed Afridi Deputy Chief, Health Sector Mr. Afsar Said Chief Planning Officer, School & Literacy Department Mr. Naseer Khan Khattak Deputy Director of Planning & Development, Higher Education Department Mr. Nafees Anwar Assistant Director of Planning & Development, Higher Education Department Mr. Anwar Ahmad Khawaja Chief Planning Officer, Higher Education Department Mr. Arbab Rifaqat Ali Statistical Officer, Higher Education Department Mr. Syed Bilal Khisro Chief of Earthquake Reconstruction Cell, Planning & Development Department Mr.Abdur Rashid EDO (Executive District Officer), School & Literacy Department of Battagram District Mr. Bakht Zadkan DO (District Officer) for Girls Schools, School & Literacy Department of Battagram District Mr. Faizur Rahman Deputy DO for Boys Schools, School & Literacy Department of Battagram District Mr. Abdul Qayoum Assitant DO for monitoring in Circle Coloney Battagram of Boys Schools, School & Literacy Department of Battagram District Mr. Muhammad Younas Assitant DO for monitoring in Circle Karg Allai of Boys Schools, School & Literacy Department of Battagram District Dr.Atla ur Pehmah Pathologist, DHQ Hospital Battagram Dr. Abdul Khalgn TB control officer, DHQ Hospital Battagram Dr.Hanig TB, DHQ Hospital Battagram Dr.Nasir Surgent, DHQ Hospital Battagram Dr. Shaza Reshid Senior Female Officer, Ob/Gy, DHQ Hospital Battagram Dr. Hazhazala Gynecologist, DHQ Hospital Battagram Dr. Amjet Dental Technichian, DHQ Hospital Battagram Dr. Musa Karim Refractionist, DHQ Hospital Battagram Dr. Aptal Food Opthalmologist, DHQ Hospital Battagram Dr. Abdul Rafut Opthalmologist(Surgery), DHQ Hospital Battagram Dr.Abdura Kharig Pediatrichian, DHQ Hospital Battagram Dr. Nasim Casuality, DHQ Hospital Battagram Dr. Tahir Aziz Casuality, DHQ Hospital Battagram Dr. Ehat Eslem Casuality, DHQ Hospital Battagram Mr. Sabir Senior Cleark, DHQ Hospital Battagram Mr. Jeharzef Assistant Account Branch, DHQ Hospital Battagram Dr. Mehboob-ur-Reham Medical Superintendent, DHQ Hospital Battagram Dr. Aha-ur Rehman Pathologist, DHQ Hospital Battagram Dr. Sar Bulaud Medical Superintendent, RHC Banna Mr. Mohammad Araz Cleark, EDO,Health Dr.Muhammad Younis EDO, EDO,Health Dr. Abdul Khalig District T.B. Control Officer, District T.B. Control Office Dr. Muhammad Saleem Medical Officer, RHC Kuza Banda Dr. Muhammad Saleem Medical Superintendent, RHC Kuza Banda Mr.Irshad Muhhamad Dispenser, CD Kuza Banda Mr.Shah Alem MO, CH Takot Mr. Ataurrehman Dispenser, CH Takot Ata Urrehman Medical Technitian, CH Thakot Said Maman Medical Technitian, BHU Shumlai Mr. horama Hagerac Dispenser, BHU Shungli Payeen Ms.Chan LHV, BHU Shungli Payeen Ghulam Hazrat Medical Technitian, BHU Shungli Payeen Abdullah Dispenser, BHU Kharari Mr. Aftab Howsainshahi Computer operator for EDO Health, BHU S.B.Kot

AP-6 Mr. Taj Bar Medical Technician, BHU Battley Musharaf Khan Medical Technitian, BHU Argoshorri Sultan Muhammael Medical Technitian, BHU Pomong Said Ahmed Saeed Medical Technitian, BHU Battamori Ali Zar Medical Technitian, BHU Hulal Batkool Prince Muhammad Nawax Allai Medical Technitian, BHU Biari Mohammed Younis Dispenser, BHU Tailous Mukhtiar Ullah BHU Charbagh Dr.Repthifhaet MS, DHQ Abbotabad Dr.Hifzur Rehuman Dupty Superintendent, DHQ Mansera Zaffar Igbal Disrict Coodnation Officer, Disrict Coodnation Office Niaz Muhammad Sub Engineer, EDO(W&S) Yousaf Shah Assistant Director, EDO(W&S) Iqbal Muhammad Sub Engineer, EDO(W&S) Mr.Rahim Zada Chief planning officer, Health Dept.Gov.of NWFP Dr. Shaheen Afridi Health Sector Reform unit, Health Dept.Gov.of NWFP Dr.Jalil ur Rahman Director of Helath Services, Health Dept.Gov.of NWFP Mrs.Zahida Perree LHV, MCHC Battgram Dr. Martin Awori Head of field office Shangia(Kohistan), WHO Islamabad Dr. T.Zeribi Environmental Health Officer, WHO Islamabad Dr. Rayana Bu-Hakah Desk Officer, WHO Islamabad

Embassy of Japan Takehiro OKUBO First Secretary, Economic Department Hironobu TASHIRO Second Secretary

JICA Pakistan Office Takao KAIBARA Resident Representative Sachiko MISUMI Acting Resident Representative Mohmood A.Jilani Deputy Resident Representative & Chief Programme Officer Shinsaku FUKAZAWA Deputy Resident Representative Mitsunobu INABA Deputy Resident Representative Hiroshi IMAI Group III Global Environment Department

JICS Office Masahiro NAGASAKU Program Manager, Project Management Dept. Hidekazu TANEMURA Project Management Dept. Tokumitsu KOBAYASHI Project Management Dept. Mr. Suleman JAMES Coordinator, JICS Project Office

AP-7

ANNEX

ANNEX 1: DRAWING LIST (HEALTH SECTOR)

[Drawing List]

District Headquarters Hospital (DHQ) Battagram – General Plot Plan...... AN1-1 District Headquarters Hospital (DHQ) Battagram – Main Hospital – Floor Plan-1 (GF-1/2) ...... AN1-2 District Headquarters Hospital (DHQ) Battagram – Main Hospital – Floor Plan-2 (GF-2/2) ...... AN1-3 District Headquarters Hospital (DHQ) Battagram – Main Hospital – Floor Plan-3 (1F-1/2)...... AN1-4 District Headquarters Hospital (DHQ) Battagram – Main Hospital – Floor Plan-4 (1F-2/2)...... AN1-5 District Headquarters Hospital (DHQ) Battagram – Main Hospital – Floor Plan-5 (2F-1/2)...... AN1-6 District Headquarters Hospital (DHQ) Battagram – Main Hospital – Floor Plan-6 (2F-2/2)...... AN1-7 District Headquarters Hospital (DHQ) Battagram – Main Hospital – Sections ...... AN1-8 District Headquarters Hospital (DHQ) Battagram – OPD – General Floor Plan-1 (GF)...... AN1-9 District Headquarters Hospital (DHQ) Battagram – OPD – General Floor Plan-2 (1F)...... AN1-10 District Headquarters Hospital (DHQ) Battagram – OPD – Sections ...... AN1-11 District Headquarters Hospital (DHQ) Battagram – TB Center – Floor Plan...... AN1-12 District Headquarters Hospital (DHQ) Battagram – TB Center – Sections ...... AN1-13 District Headquarters Hospital (DHQ) Battagram – EDO – Ground Floor Plan ...... AN1-14 District Headquarters Hospital (DHQ) Battagram – EDO – 1st Floor Plan...... AN1-15 District Headquarters Hospital (DHQ) Battagram – EDO – Sections ...... AN1-16 District Headquarters Hospital (DHQ) Battagram – MCHC – Floor Plan...... AN1-17 District Headquarters Hospital (DHQ) Battagram – MCHC – Section Detail...... AN1-18 District Headquarters Hospital (DHQ) Battagram – Casualty – Floor Plan...... AN1-19 District Headquarters Hospital (DHQ) Battagram – Casualty – Sections...... AN1-20 District Headquarters Hospital (DHQ) Battagram – Mortuary – Floor Plan...... AN1-21 District Headquarters Hospital (DHQ) Battagram – Mortuary – Sections...... AN1-22 Rural Health Center (RHC) Banna – Plot Plan ...... AN1-23 Rural Health Center (RHC) Banna – Main Hospital – General Floor Plan-1 ...... AN1-24 Rural Health Center (RHC) Banna – Main Hospital – General Floor Plan-2 ...... AN1-25 Rural Health Center (RHC) Banna – Main Hospital – Section Detail-1...... AN1-26 Rural Health Center (RHC) Banna – Main Hospital – Section Detail-2...... AN1-27 Rural Health Center (RHC) Banna – Main Hospital – Section Detail-3...... AN1-28 Rural Health Center (RHC) Banna – Residence Type I – Floor Plan ...... AN1-29 Rural Health Center (RHC) Banna – Residence Type I – Sections ...... AN1-30 Rural Health Center (RHC) Banna – Residence Type II – Floor Plan...... AN1-31 Rural Health Center (RHC) Banna – Residence Type III – Floor Plan ...... AN1-32 Civil Hospital (CH) Thakot – Site Plan ...... AN1-33 Civil Hospital (CH) Thakot – OPD – Floor Plan...... AN1-34 Civil Hospital (CH) Thakot – OPD – Section A-A...... AN1-35 Civil Hospital (CH) Thakot – OPD – Section B-B...... AN1-36 Basic Health Unit – Plan (12G5S)...... AN1-37 Basic Health Unit – Section A-A (12G5S)...... AN1-38 Basic Health Unit – Plan (12G7S)...... AN1-39 Basic Health Unit – Section A-A (12G7S)...... AN1-40 Basic Health Unit – OPD – Floor Plan ...... AN1-41 Basic Health Unit – OPD – Section A-A ...... AN1-42 Basic Health Unit – OPD – Section B-B ...... AN1-43